Alexander Kuhlmann1, J-Matthias Graf von der Schulenburg2. 1. Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hanover, Germany. ak@ivbl.uni-hannover.de. 2. Center for Health Economics Research Hannover (CHERH), Leibniz Universität Hannover, Otto-Brenner-Straße 1, 30159, Hanover, Germany.
Abstract
BACKGROUND: In 2009, the European Medicines Agency granted approval for two higher-valent pneumococcal conjugate vaccines. This study aims to evaluate the cost-effectiveness of universal infant (<2 years old) vaccination with a 13-valent pneumococcal conjugate vaccine (PCV13) in comparison with a 10-valent pneumococcal conjugate vaccine (PCV10) for the prevention of pneumococcal disease in Germany. METHODS: A population-based Markov model was developed to estimate the impact of PCV13 and PCV10 on invasive pneumococcal disease (IPD), non-invasive pneumonia (PNE), and acute otitis media (AOM) over a time horizon of 50 years. The model included the effects of the historical vaccination scheme in infants as well as indirect herd effects and replacement disease. We used German epidemiological data to calculate episodes of IPD, PNE, and AOM, as well as direct and indirect effects of the vaccination. Parameter uncertainty was tested in univariate and probabilistic sensitivity analyses. RESULTS: In the base-case analysis, the ICER of PCV13 versus PCV10 infant vaccination was EUR 9826 per quality-adjusted life-year (QALY) gained or EUR 5490 per life-year (LY) gained from the societal perspective and EUR 3368 per QALY gained or EUR 1882 per LY gained from the perspective of the German statutory health insurance. The results were particularly sensitive to the magnitude of indirect effects of both vaccines. CONCLUSIONS: Universal infant vaccination with PCV13 is likely to be a cost-effective intervention compared with PCV10 within the German health care system, if additional net indirect effects of PCV13 vaccination are significant.
BACKGROUND: In 2009, the European Medicines Agency granted approval for two higher-valent pneumococcal conjugate vaccines. This study aims to evaluate the cost-effectiveness of universal infant (<2 years old) vaccination with a 13-valent pneumococcal conjugate vaccine (PCV13) in comparison with a 10-valent pneumococcal conjugate vaccine (PCV10) for the prevention of pneumococcal disease in Germany. METHODS: A population-based Markov model was developed to estimate the impact of PCV13 and PCV10 on invasive pneumococcal disease (IPD), non-invasive pneumonia (PNE), and acute otitis media (AOM) over a time horizon of 50 years. The model included the effects of the historical vaccination scheme in infants as well as indirect herd effects and replacement disease. We used German epidemiological data to calculate episodes of IPD, PNE, and AOM, as well as direct and indirect effects of the vaccination. Parameter uncertainty was tested in univariate and probabilistic sensitivity analyses. RESULTS: In the base-case analysis, the ICER of PCV13 versus PCV10 infant vaccination was EUR 9826 per quality-adjusted life-year (QALY) gained or EUR 5490 per life-year (LY) gained from the societal perspective and EUR 3368 per QALY gained or EUR 1882 per LY gained from the perspective of the German statutory health insurance. The results were particularly sensitive to the magnitude of indirect effects of both vaccines. CONCLUSIONS: Universal infant vaccination with PCV13 is likely to be a cost-effective intervention compared with PCV10 within the German health care system, if additional net indirect effects of PCV13 vaccination are significant.
Authors: Raymond A Farkouh; Rogier M Klok; Maarten J Postma; Craig S Roberts; David R Strutton Journal: Expert Rev Vaccines Date: 2012-11-21 Impact factor: 5.217
Authors: Karen Richards Tyo; Melissa M Rosen; Wu Zeng; Mabel Yap; Keng Ho Pwee; Li Wei Ang; Donald S Shepard Journal: Vaccine Date: 2011-07-13 Impact factor: 3.641
Authors: Matthew R Moore; Ruth Link-Gelles; William Schaffner; Ruth Lynfield; Catherine Lexau; Nancy M Bennett; Susan Petit; Shelley M Zansky; Lee H Harrison; Arthur Reingold; Lisa Miller; Karen Scherzinger; Ann Thomas; Monica M Farley; Elizabeth R Zell; Thomas H Taylor; Tracy Pondo; Loren Rodgers; Lesley McGee; Bernard Beall; James H Jorgensen; Cynthia G Whitney Journal: Lancet Infect Dis Date: 2015-02-03 Impact factor: 25.071
Authors: Steven B Black; Henry R Shinefield; Stella Ling; John Hansen; Bruce Fireman; David Spring; Jack Noyes; Edwin Lewis; Paula Ray; Janelle Lee; Jill Hackell Journal: Pediatr Infect Dis J Date: 2002-09 Impact factor: 2.129
Authors: Sarah Pugh; Matt Wasserman; Margaret Moffatt; Susana Marques; Juan Manuel Reyes; Victor A Prieto; Davy Reijnders; Mark H Rozenbaum; Juha Laine; Heidi Åhman; Raymond Farkouh Journal: Infect Dis Ther Date: 2020-02-24