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Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model.
BMJ Open. 2016 11 30; 6(11):e010776.BO

Abstract

OBJECTIVES

In 2010, the 13-valent pneumococcal conjugate vaccine (PCV-13) replaced the 7-valent vaccine (introduced in 2006) for vaccination against invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) in the UK. Using recent evidence on the impact of PCVs and epidemiological changes in the UK, we performed a cost-effectiveness analysis (CEA) to compare the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with PCV-13 in the ongoing national vaccination programme.

DESIGN

CEA was based on a published Markov model. The base-case scenario accounted only for direct medical costs. Work days lost were considered in alternative scenarios.

SETTING

Calculations were based on serotype and disease-specific vaccine efficacies, serotype distributions and UK incidence rates and medical costs.

POPULATION

Health benefits and costs related to IPD, pneumonia and AOM were accumulated over the lifetime of a UK birth cohort.

INTERVENTIONS

Vaccination of infants at 2, 4 and 12 months with PHiD-CV or PCV-13, assuming complete coverage and adherence.

OUTCOME MEASURES

The incremental cost-effectiveness ratio (ICER) was computed by dividing the difference in costs between the programmes by the difference in quality-adjusted life-years (QALY).

RESULTS

Under our model assumptions, both vaccines had a similar impact on IPD and pneumonia, but PHiD-CV generated a greater reduction in AOM cases (161 918), AOM-related general practitioner consultations (31 070) and tympanostomy tube placements (2399). At price parity, PHiD-CV vaccination was dominant over PCV-13, saving 734 QALYs as well as £3.68 million to the National Health Service (NHS). At the lower list price of PHiD-CV, the cost-savings would increase to £45.77 million.

CONCLUSIONS

This model projected that PHiD-CV would provide both incremental health benefits and cost-savings compared with PCV-13 at price parity. Using PHiD-CV could result in substantial budget savings to the NHS. These savings could be used to implement other life-saving interventions.

Authors+Show Affiliations

GSK Vaccines, Wavre, Belgium.Eclipse, Tervuren, Belgium.GSK Pharma, London, UK.GSK Vaccines, Wavre, Belgium.

Pub Type(s)

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

Language

eng

PubMed ID

27903558

Citation

Delgleize, Emmanuelle, et al. "Cost-effectiveness Analysis of Routine Pneumococcal Vaccination in the UK: a Comparison of the PHiD-CV Vaccine and the PCV-13 Vaccine Using a Markov Model." BMJ Open, vol. 6, no. 11, 2016, pp. e010776.
Delgleize E, Leeuwenkamp O, Theodorou E, et al. Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model. BMJ Open. 2016;6(11):e010776.
Delgleize, E., Leeuwenkamp, O., Theodorou, E., & Van de Velde, N. (2016). Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model. BMJ Open, 6(11), e010776. https://doi.org/10.1136/bmjopen-2015-010776
Delgleize E, et al. Cost-effectiveness Analysis of Routine Pneumococcal Vaccination in the UK: a Comparison of the PHiD-CV Vaccine and the PCV-13 Vaccine Using a Markov Model. BMJ Open. 2016 11 30;6(11):e010776. PubMed PMID: 27903558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness analysis of routine pneumococcal vaccination in the UK: a comparison of the PHiD-CV vaccine and the PCV-13 vaccine using a Markov model. AU - Delgleize,Emmanuelle, AU - Leeuwenkamp,Oscar, AU - Theodorou,Eleni, AU - Van de Velde,Nicolas, Y1 - 2016/11/30/ PY - 2016/12/2/entrez PY - 2016/12/3/pubmed PY - 2018/1/2/medline KW - HEALTH ECONOMICS KW - IMMUNOLOGY SP - e010776 EP - e010776 JF - BMJ open JO - BMJ Open VL - 6 IS - 11 N2 - OBJECTIVES: In 2010, the 13-valent pneumococcal conjugate vaccine (PCV-13) replaced the 7-valent vaccine (introduced in 2006) for vaccination against invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) in the UK. Using recent evidence on the impact of PCVs and epidemiological changes in the UK, we performed a cost-effectiveness analysis (CEA) to compare the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with PCV-13 in the ongoing national vaccination programme. DESIGN: CEA was based on a published Markov model. The base-case scenario accounted only for direct medical costs. Work days lost were considered in alternative scenarios. SETTING: Calculations were based on serotype and disease-specific vaccine efficacies, serotype distributions and UK incidence rates and medical costs. POPULATION: Health benefits and costs related to IPD, pneumonia and AOM were accumulated over the lifetime of a UK birth cohort. INTERVENTIONS: Vaccination of infants at 2, 4 and 12 months with PHiD-CV or PCV-13, assuming complete coverage and adherence. OUTCOME MEASURES: The incremental cost-effectiveness ratio (ICER) was computed by dividing the difference in costs between the programmes by the difference in quality-adjusted life-years (QALY). RESULTS: Under our model assumptions, both vaccines had a similar impact on IPD and pneumonia, but PHiD-CV generated a greater reduction in AOM cases (161 918), AOM-related general practitioner consultations (31 070) and tympanostomy tube placements (2399). At price parity, PHiD-CV vaccination was dominant over PCV-13, saving 734 QALYs as well as £3.68 million to the National Health Service (NHS). At the lower list price of PHiD-CV, the cost-savings would increase to £45.77 million. CONCLUSIONS: This model projected that PHiD-CV would provide both incremental health benefits and cost-savings compared with PCV-13 at price parity. Using PHiD-CV could result in substantial budget savings to the NHS. These savings could be used to implement other life-saving interventions. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/27903558/Cost_effectiveness_analysis_of_routine_pneumococcal_vaccination_in_the_UK:_a_comparison_of_the_PHiD_CV_vaccine_and_the_PCV_13_vaccine_using_a_Markov_model_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=27903558 DB - PRIME DP - Unbound Medicine ER -