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Cost-Effectiveness Evaluation of the 10-Valent Pneumococcal Non-typeable Haemophilus influenzae Protein D Conjugate Vaccine and 13-Valent Pneumococcal Vaccine in Japanese Children.

Shiragami M, Mizukami A, Leeuwenkamp O, Mrkvan T, Delgleize E, Kurono Y, Iwata S - Infect Dis Ther (2014)

Bottom Line: Incremental benefits in terms of costs and quality-adjusted life-year and cost-effectiveness were assessed.This was largely due to a reduction in highly prevalent acute otitis media.Sensitivity analyses showed robustness of model outcome to changes in key model parameters and substantiated that the model outcome was consistently driven by the incremental benefit of PHiD-CV in averting acute otitis media.

View Article: PubMed Central - PubMed

Affiliation: Social and Administrative Pharmacy Science, School of Pharmacy, Nihon University, Funabashi-shi, Chiba, Japan.

ABSTRACT

Introduction: Diseases caused by Streptococcus pneumoniae represent a major public health problem. The purpose of this study was to compare, in the Japanese context, the projected health benefits, costs and cost-effectiveness of the latest generation of pneumococcal conjugate vaccines which may provide important insight into the potential public health impact of interventions in the context of local disease-specific epidemiology.

Methods: A Markov model was used to compare two vaccination strategies which involve routine infant immunization with either the 13-valent pneumococcal conjugate vaccine (PCV-13; Prevenar 13™, Pfizer, Pearl River, NY, USA) or the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV; Synflorix™, GlaxoSmithKline Biologicals SA, Rixensart, Belgium) over a time horizon of 5 years from the healthcare provider and societal perspectives. Estimates for key model parameters were obtained from locally available databases and published literature. Incremental benefits in terms of costs and quality-adjusted life-year and cost-effectiveness were assessed.

Results: A 3 + 1 vaccination schedule for infants with PHiD-CV is expected to have a similar impact on invasive pneumococcal disease and pneumonia and a larger impact on acute otitis media-related outcomes compared with PCV-13. Assuming price parity for these vaccines, the model projected that vaccination with PHiD-CV would result in cost savings of 1.9 and 3.9 billion Japanese yen from the provider and societal perspectives, respectively. This was largely due to a reduction in highly prevalent acute otitis media. Vaccination with PHiD-CV was expected to generate a gain of 433 quality-adjusted life-years compared to PCV-13 translating into dominance over PCV-13. Sensitivity analyses showed robustness of model outcome to changes in key model parameters and substantiated that the model outcome was consistently driven by the incremental benefit of PHiD-CV in averting acute otitis media.

Conclusion: In comparison to PCV-13, vaccination with PHiD-CV is projected to be cost saving for Japan from both the healthcare provider and societal perspectives.

No MeSH data available.


Related in: MedlinePlus

Model structure. AOM acute otitis media, B bacteraemia, M meningitis, PCV-13 13-valent pneumococcal conjugate vaccine, PHiD-CV 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine, P pneumonia
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Fig1: Model structure. AOM acute otitis media, B bacteraemia, M meningitis, PCV-13 13-valent pneumococcal conjugate vaccine, PHiD-CV 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine, P pneumonia

Mentions: The basic model construct is visualized in Fig. 1. Individuals were followed in the age-stratified model over a time horizon of 5 years with a cycle length of 1 month. During each monthly cycle, the probability of an individual entering a specific health state is governed by age-specific Sp and NTHi-AOM incidence rates and applicable vaccine efficacy (VE) levels. These transition probabilities determine hospitalization rates and frequency of medical visits in conjunction with the respective diseases considered in the model. To the respective disease conditions, unit costs and disease-specific disutilities were further added. In each cycle of the model, cost consequences and QALYs were estimated so that costs and QALY losses accumulated until the 5 year time horizon and converted into a corresponding incremental cost-effectiveness ratio (ICER) expressed in terms of costs per QALY gained.Fig. 1


Cost-Effectiveness Evaluation of the 10-Valent Pneumococcal Non-typeable Haemophilus influenzae Protein D Conjugate Vaccine and 13-Valent Pneumococcal Vaccine in Japanese Children.

Shiragami M, Mizukami A, Leeuwenkamp O, Mrkvan T, Delgleize E, Kurono Y, Iwata S - Infect Dis Ther (2014)

Model structure. AOM acute otitis media, B bacteraemia, M meningitis, PCV-13 13-valent pneumococcal conjugate vaccine, PHiD-CV 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine, P pneumonia
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4363214&req=5

Fig1: Model structure. AOM acute otitis media, B bacteraemia, M meningitis, PCV-13 13-valent pneumococcal conjugate vaccine, PHiD-CV 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine, P pneumonia
Mentions: The basic model construct is visualized in Fig. 1. Individuals were followed in the age-stratified model over a time horizon of 5 years with a cycle length of 1 month. During each monthly cycle, the probability of an individual entering a specific health state is governed by age-specific Sp and NTHi-AOM incidence rates and applicable vaccine efficacy (VE) levels. These transition probabilities determine hospitalization rates and frequency of medical visits in conjunction with the respective diseases considered in the model. To the respective disease conditions, unit costs and disease-specific disutilities were further added. In each cycle of the model, cost consequences and QALYs were estimated so that costs and QALY losses accumulated until the 5 year time horizon and converted into a corresponding incremental cost-effectiveness ratio (ICER) expressed in terms of costs per QALY gained.Fig. 1

Bottom Line: Incremental benefits in terms of costs and quality-adjusted life-year and cost-effectiveness were assessed.This was largely due to a reduction in highly prevalent acute otitis media.Sensitivity analyses showed robustness of model outcome to changes in key model parameters and substantiated that the model outcome was consistently driven by the incremental benefit of PHiD-CV in averting acute otitis media.

View Article: PubMed Central - PubMed

Affiliation: Social and Administrative Pharmacy Science, School of Pharmacy, Nihon University, Funabashi-shi, Chiba, Japan.

ABSTRACT

Introduction: Diseases caused by Streptococcus pneumoniae represent a major public health problem. The purpose of this study was to compare, in the Japanese context, the projected health benefits, costs and cost-effectiveness of the latest generation of pneumococcal conjugate vaccines which may provide important insight into the potential public health impact of interventions in the context of local disease-specific epidemiology.

Methods: A Markov model was used to compare two vaccination strategies which involve routine infant immunization with either the 13-valent pneumococcal conjugate vaccine (PCV-13; Prevenar 13™, Pfizer, Pearl River, NY, USA) or the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV; Synflorix™, GlaxoSmithKline Biologicals SA, Rixensart, Belgium) over a time horizon of 5 years from the healthcare provider and societal perspectives. Estimates for key model parameters were obtained from locally available databases and published literature. Incremental benefits in terms of costs and quality-adjusted life-year and cost-effectiveness were assessed.

Results: A 3 + 1 vaccination schedule for infants with PHiD-CV is expected to have a similar impact on invasive pneumococcal disease and pneumonia and a larger impact on acute otitis media-related outcomes compared with PCV-13. Assuming price parity for these vaccines, the model projected that vaccination with PHiD-CV would result in cost savings of 1.9 and 3.9 billion Japanese yen from the provider and societal perspectives, respectively. This was largely due to a reduction in highly prevalent acute otitis media. Vaccination with PHiD-CV was expected to generate a gain of 433 quality-adjusted life-years compared to PCV-13 translating into dominance over PCV-13. Sensitivity analyses showed robustness of model outcome to changes in key model parameters and substantiated that the model outcome was consistently driven by the incremental benefit of PHiD-CV in averting acute otitis media.

Conclusion: In comparison to PCV-13, vaccination with PHiD-CV is projected to be cost saving for Japan from both the healthcare provider and societal perspectives.

No MeSH data available.


Related in: MedlinePlus