Economic assessment of pneumococal vaccines in Chile

Abstract

Objective: To determine the cost-effectiveness of conjugated pneumococcal vaccines, PHiD-CV and PCV-13, for Chile.

Materials and methods: We evaluated the cost effectiveness of both vaccines for Chile. Community acquired pneumonias (CAP; hospitalized and outpatients), invasive pneumococcal diseases (IPD; hospitalized bacteremia, meningitis and its sequelae) acute otitis media (AOM; medical visits and myringotomies), and PAHO revolving fund 2012 vaccine prices were considered in the analysis.

The model assesses the medical and economic impact of both vaccines over a newborn cohort during a lifetime. Univariate and probabilistic sensitivity analysis (PSA) to assess the robustness of our cost effectiveness result were performed.

Results: We estimate that these vaccines can prevent 15,000 CAPs, 92-96 pneumococcal meningitis, 101-105 hospitalized pneumococcal bacteraemias and 21,000-28,000 AOMs per vaccinated cohort. PCV-13 showed additional benefits on IPD, while PHiD-CV showed additional benefits on AOM. PHiD-CV prevents 142 million pesos more than PCV-13 on treatment costs, and the vaccine costs 745 million pesos less. The cost utility analysis shows that both vaccines are cost effective for Chile. PHiD-CV generates 19 more quality adjusted life years (QALYs) than PCV-13 at a lower cost (-849 million pesos), being dominant in the deterministic analysis. PSA shows PHiD-CV is less costly than PCV-13 in 100% of the replicas, confirming the robustness of our estimations.

Conclusions: In our analyses, both vaccines demonstrate reduction in the burden of pneumococcal disease, as well as cost effectiveness for Chile. PHiD-CV appears more cost effective, saving 849 million pesos per vaccinated cohort versus PCV-13.