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Vaccine
Jun 10, 2013;31 (26): 2839-47.

Cost-utility analysis of 10- and 13-valent pneumococcal conjugate vaccines: protection at what price in the Thai context?

Wantanee Kulpeng, Pattara Leelahavarong, Waranya Rattanavipapong, Vorasith Sornsrivichai, Henry C Baggett, Aronrag Meeyai, Warunee Punpanich, Yot Teerawattananon
Author Information
  1. Wantanee Kulpeng: Health Intervention and Technology Assessment Program (HITAP), 6th Floor, 6th Building, Department of Health, Ministry of Public Health, Tiwanon Rd., Muang, Nonthaburi 11000, Thailand. wantanee.k@hitap.net
PMID: 23588084 DOI: 10.1016/j.vaccine.2013.03.047

Abstract

OBJECTIVE: This study aims to evaluate the costs and outcomes of offering the 10-valent pneumococcal conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13) in Thailand compared to the current situation of no PCV vaccination.
METHODS: Two vaccination schedules were considered: two-dose primary series plus a booster dose (2+1) and three-dose primary series plus a booster dose (3+1). A cost-utility analysis was conducted using a societal perspective. A Markov simulation model was used to estimate the relevant costs and health outcomes for a lifetime horizon. Costs were collected and values were calculated for the year 2010. The results were reported as incremental cost-effectiveness ratios (ICERs) in Thai Baht (THB) per quality adjusted life year (QALY) gained, with future costs and outcomes being discounted at 3% per annum. One-way sensitivity analysis and probabilistic sensitivity analysis using a Monte Carlo simulation were performed to assess parameter uncertainty.
RESULTS: Under the base case-scenario of 2+1 dose schedule and a five-year protection, without indirect vaccine effects, the ICER for PCV10 and PCV13 were THB 1,368,072 and THB 1,490,305 per QALY gained, respectively. With indirect vaccine effects, the ICER of PCV10 was THB 519,399, and for PCV13 was THB 527,378. The model was sensitive to discount rate, the change in duration of vaccine protection and the incidence of pneumonia for all age groups.
CONCLUSIONS: At current prices, PCV10 and PCV13 are not cost-effective in Thailand. Inclusion of indirect vaccine effects substantially reduced the ICERs for both vaccines, but did not result in cost effectiveness.

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Grants

  1. CC999999/Intramural CDC HHS

MeSH Term

Adult
Cost-Benefit Analysis
Humans
Immunization Schedule
Incidence
Male
Monte Carlo Method
Pneumococcal Infections
Pneumococcal Vaccines
Pneumonia, Pneumococcal
Quality-Adjusted Life Years
Thailand
Vaccination
Vaccines, Conjugate

Chemicals

10-valent pneumococcal conjugate vaccine
13-valent pneumococcal vaccine
Pneumococcal Vaccines
Vaccines, Conjugate
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 11

Word Cloud

Created with Highcharts 10.0.0vaccineTHBPCV10PCV13analysiscostsoutcomespneumococcalconjugatedoseperprotectionindirecteffects13-valentThailandcurrentvaccinationprimaryseriesplusbooster2+1usingsimulationmodelyearICERsThaiQALYgainedsensitivityICER1OBJECTIVE:studyaimsevaluateoffering10-valentcomparedsituationPCVMETHODS:Twoschedulesconsidered:two-dosethree-dose3+1cost-utilityconductedsocietalperspectiveMarkovusedestimaterelevanthealthlifetimehorizonCostscollectedvaluescalculated2010resultsreportedincrementalcost-effectivenessratiosBahtqualityadjustedlifefuturediscounted3%annumOne-wayprobabilisticMonteCarloperformedassessparameteruncertaintyRESULTS:basecase-scenarioschedulefive-yearwithout368072490305respectively519399527378sensitivediscountratechangedurationincidencepneumoniaagegroupsCONCLUSIONS:pricescost-effectiveInclusionsubstantiallyreducedvaccinesresultcosteffectivenessCost-utility10-vaccines:pricecontext?

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