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Modeling the impact of the 7-valent pneumococcal conjugate vaccine in Chinese infants: an economic analysis of a compulsory vaccination.
BMC Health Serv Res. 2014 Feb 07; 14:56.BH

Abstract

BACKGROUND

The purpose of this study was to compare, from a Chinese societal perspective, the projected health benefits, costs, and cost-effectiveness of adding pneumococcal conjugate heptavalent vaccine (PCV-7) to the routine compulsory child immunization schedule.

METHODS

A decision-tree model, with data and assumptions adapted for relevance to China, was developed to project the health outcomes of PCV-7 vaccination (compared with no vaccination) over a 5-year period as well as a lifetime. The vaccinated birth cohort included 16,000,000 children in China. A 2 + 1 dose schedule at US$136.51 per vaccine dose was used in the base-case analysis. One-way sensitivity analysis was used to test the robustness of the model. The impact of a net indirect effect (herd immunity) was evaluated. Outcomes are presented in terms of the saved disease burden, costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio.

RESULTS

In a Chinese birth cohort, a PCV-7 vaccination program would reduce the number of pneumococcus-related infections by at least 32% and would prevent 2,682 deaths in the first 5 years of life, saving $1,190 million in total costs and gaining an additional 9,895 QALYs (discounted by 3%). The incremental cost per QALY was estimated to be $530,354. When herd immunity was taken into account, the cost per QALY was estimated to be $95,319. The robustness of the model was influenced mainly by the PCV-7 cost per dose, effectiveness herd immunity and incidence of pneumococcal diseases. With and without herd immunity, the break-even costs in China were $29.05 and $25.87, respectively.

CONCLUSIONS

Compulsory routine infant vaccination with PCV-7 is projected to substantially reduce pneumococcal disease morbidity, mortality, and related costs in China. However, a universal vaccination program with PCV-7 is not cost-effective at the willingness-to-pay threshold that is currently recommended for China by the World Health Organization.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableMedical Decision and Economic Group, Department of Pharmacy, Renji Hospital, affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China. wbwithtg@hotmail.com.

Pub Type(s)

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

Language

eng

PubMed ID

24507480

Citation

Che, Datian, et al. "Modeling the Impact of the 7-valent Pneumococcal Conjugate Vaccine in Chinese Infants: an Economic Analysis of a Compulsory Vaccination." BMC Health Services Research, vol. 14, 2014, p. 56.
Che D, Zhou H, He J, et al. Modeling the impact of the 7-valent pneumococcal conjugate vaccine in Chinese infants: an economic analysis of a compulsory vaccination. BMC Health Serv Res. 2014;14:56.
Che, D., Zhou, H., He, J., & Wu, B. (2014). Modeling the impact of the 7-valent pneumococcal conjugate vaccine in Chinese infants: an economic analysis of a compulsory vaccination. BMC Health Services Research, 14, 56. https://doi.org/10.1186/1472-6963-14-56
Che D, et al. Modeling the Impact of the 7-valent Pneumococcal Conjugate Vaccine in Chinese Infants: an Economic Analysis of a Compulsory Vaccination. BMC Health Serv Res. 2014 Feb 7;14:56. PubMed PMID: 24507480.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modeling the impact of the 7-valent pneumococcal conjugate vaccine in Chinese infants: an economic analysis of a compulsory vaccination. AU - Che,Datian, AU - Zhou,Hua, AU - He,Jinchun, AU - Wu,Bin, Y1 - 2014/02/07/ PY - 2013/04/29/received PY - 2014/01/28/accepted PY - 2014/2/11/entrez PY - 2014/2/11/pubmed PY - 2014/9/27/medline SP - 56 EP - 56 JF - BMC health services research JO - BMC Health Serv Res VL - 14 N2 - BACKGROUND: The purpose of this study was to compare, from a Chinese societal perspective, the projected health benefits, costs, and cost-effectiveness of adding pneumococcal conjugate heptavalent vaccine (PCV-7) to the routine compulsory child immunization schedule. METHODS: A decision-tree model, with data and assumptions adapted for relevance to China, was developed to project the health outcomes of PCV-7 vaccination (compared with no vaccination) over a 5-year period as well as a lifetime. The vaccinated birth cohort included 16,000,000 children in China. A 2 + 1 dose schedule at US$136.51 per vaccine dose was used in the base-case analysis. One-way sensitivity analysis was used to test the robustness of the model. The impact of a net indirect effect (herd immunity) was evaluated. Outcomes are presented in terms of the saved disease burden, costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio. RESULTS: In a Chinese birth cohort, a PCV-7 vaccination program would reduce the number of pneumococcus-related infections by at least 32% and would prevent 2,682 deaths in the first 5 years of life, saving $1,190 million in total costs and gaining an additional 9,895 QALYs (discounted by 3%). The incremental cost per QALY was estimated to be $530,354. When herd immunity was taken into account, the cost per QALY was estimated to be $95,319. The robustness of the model was influenced mainly by the PCV-7 cost per dose, effectiveness herd immunity and incidence of pneumococcal diseases. With and without herd immunity, the break-even costs in China were $29.05 and $25.87, respectively. CONCLUSIONS: Compulsory routine infant vaccination with PCV-7 is projected to substantially reduce pneumococcal disease morbidity, mortality, and related costs in China. However, a universal vaccination program with PCV-7 is not cost-effective at the willingness-to-pay threshold that is currently recommended for China by the World Health Organization. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/24507480/Modeling_the_impact_of_the_7_valent_pneumococcal_conjugate_vaccine_in_Chinese_infants:_an_economic_analysis_of_a_compulsory_vaccination_ L2 - https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-56 DB - PRIME DP - Unbound Medicine ER -