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The potential cost-effectiveness of infant pneumococcal vaccines in Australia.
Vaccine. 2011 Oct 19; 29(45):8077-85.V

Abstract

Over the last decade infant pneumococcal vaccination has been adopted as part of routine immunisation schedules in many developed countries. Although highly successful in many settings such as Australia and the United States, rapid serotype replacement has occurred in some European countries. Recently two pneumococcal conjugate vaccines (PCVs) with extended serotype coverage have been licensed for use, a 10-valent (PHiD-CV) and a 13-valent (PCV-13) vaccine, and offer potential replacements for the existing vaccine (PCV-7) in Australia. To evaluate the cost-effectiveness of PCV programs we developed a static, deterministic state-transition model. The perspective for costs included those to the government and healthcare system. When compared to current practice (PCV-7) both vaccines offered potential benefits, with those estimated for PHiD-CV due primarily to prevention of otitis media and PCV-13 due to a further reduction in invasive disease in Australia. At equivalent total cost to vaccinate an infant, compared to no PCV the base-case cost per QALY saved were estimated at A$64,900 (current practice, PCV-7; 3+0), A$50,200 (PHiD-CV; 3+1) and A$55,300 (PCV-13; 3+0), respectively. However, assumptions regarding herd protection, serotype protection, otitis media efficacy, and vaccination cost changed the relative cost-effectiveness of alternative PCV programs. The high proportion of current invasive disease caused by serotype 19A (as included in PCV-13) may be a decisive factor in determining vaccine policy in Australia.

Authors+Show Affiliations

School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia. a.newall@unsw.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21864617

Citation

Newall, Anthony T., et al. "The Potential Cost-effectiveness of Infant Pneumococcal Vaccines in Australia." Vaccine, vol. 29, no. 45, 2011, pp. 8077-85.
Newall AT, Creighton P, Philp DJ, et al. The potential cost-effectiveness of infant pneumococcal vaccines in Australia. Vaccine. 2011;29(45):8077-85.
Newall, A. T., Creighton, P., Philp, D. J., Wood, J. G., & MacIntyre, C. R. (2011). The potential cost-effectiveness of infant pneumococcal vaccines in Australia. Vaccine, 29(45), 8077-85. https://doi.org/10.1016/j.vaccine.2011.08.050
Newall AT, et al. The Potential Cost-effectiveness of Infant Pneumococcal Vaccines in Australia. Vaccine. 2011 Oct 19;29(45):8077-85. PubMed PMID: 21864617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The potential cost-effectiveness of infant pneumococcal vaccines in Australia. AU - Newall,Anthony T, AU - Creighton,Prudence, AU - Philp,David J, AU - Wood,James G, AU - MacIntyre,C Raina, Y1 - 2011/08/22/ PY - 2011/02/11/received PY - 2011/07/29/revised PY - 2011/08/08/accepted PY - 2011/8/26/entrez PY - 2011/8/26/pubmed PY - 2012/1/24/medline SP - 8077 EP - 85 JF - Vaccine JO - Vaccine VL - 29 IS - 45 N2 - Over the last decade infant pneumococcal vaccination has been adopted as part of routine immunisation schedules in many developed countries. Although highly successful in many settings such as Australia and the United States, rapid serotype replacement has occurred in some European countries. Recently two pneumococcal conjugate vaccines (PCVs) with extended serotype coverage have been licensed for use, a 10-valent (PHiD-CV) and a 13-valent (PCV-13) vaccine, and offer potential replacements for the existing vaccine (PCV-7) in Australia. To evaluate the cost-effectiveness of PCV programs we developed a static, deterministic state-transition model. The perspective for costs included those to the government and healthcare system. When compared to current practice (PCV-7) both vaccines offered potential benefits, with those estimated for PHiD-CV due primarily to prevention of otitis media and PCV-13 due to a further reduction in invasive disease in Australia. At equivalent total cost to vaccinate an infant, compared to no PCV the base-case cost per QALY saved were estimated at A$64,900 (current practice, PCV-7; 3+0), A$50,200 (PHiD-CV; 3+1) and A$55,300 (PCV-13; 3+0), respectively. However, assumptions regarding herd protection, serotype protection, otitis media efficacy, and vaccination cost changed the relative cost-effectiveness of alternative PCV programs. The high proportion of current invasive disease caused by serotype 19A (as included in PCV-13) may be a decisive factor in determining vaccine policy in Australia. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/21864617/The_potential_cost_effectiveness_of_infant_pneumococcal_vaccines_in_Australia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(11)01291-6 DB - PRIME DP - Unbound Medicine ER -