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Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia

OBJECTIVE: The Ministry of Health (MOH), Mongolia, is considering introducing 13-valent pneumococcal conjugate vaccine (PCV13) in its national immunization programme to prevent the burden of disease caused by Streptococcus pneumoniae. This study evaluates the cost-effectiveness and budget impact of...

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Autores principales: Sundaram, Neisha, Chen, Cynthia, Yoong, Joanne, Luvsan, Munkh-Erdene, Fox, Kimberley, Sarankhuu, Amarzaya, La Vincente, Sophie, Jit, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297341/
https://www.ncbi.nlm.nih.gov/pubmed/28109706
http://dx.doi.org/10.1016/j.vaccine.2016.12.070
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author Sundaram, Neisha
Chen, Cynthia
Yoong, Joanne
Luvsan, Munkh-Erdene
Fox, Kimberley
Sarankhuu, Amarzaya
La Vincente, Sophie
Jit, Mark
author_facet Sundaram, Neisha
Chen, Cynthia
Yoong, Joanne
Luvsan, Munkh-Erdene
Fox, Kimberley
Sarankhuu, Amarzaya
La Vincente, Sophie
Jit, Mark
author_sort Sundaram, Neisha
collection PubMed
description OBJECTIVE: The Ministry of Health (MOH), Mongolia, is considering introducing 13-valent pneumococcal conjugate vaccine (PCV13) in its national immunization programme to prevent the burden of disease caused by Streptococcus pneumoniae. This study evaluates the cost-effectiveness and budget impact of introducing PCV13 compared to no PCV vaccination in Mongolia. METHODS: The incremental cost-effectiveness ratio (ICER) of introducing PCV13 compared to no PCV vaccination was assessed using an age-stratified static multiple cohort model. The risk of various clinical presentations of pneumococcal disease (meningitis, pneumonia, non-meningitis non-pneumonia invasive pneumococcal disease and acute otitis media) at all ages for thirty birth cohorts was assessed. The analysis considered both health system and societal perspectives. A 3 + 0 vaccine schedule and price of US$3.30 per dose was assumed for the baseline scenario based on Gavi, the Vaccine Alliance’s advance market commitment tail price. RESULTS: The ICER of PCV13 introduction is estimated at US$52 per disability-adjusted life year (DALY) averted (health system perspective), and cost-saving (societal perspective). Although indirect effects of PCV have been well-documented, a conservative scenario that does not consider indirect effects estimated PCV13 introduction to cost US$79 per DALY averted (health system perspective), and US$19 per DALY averted (societal perspective). Vaccination with PCV13 is expected to cost around US$920,000 in 2016, and thereafter US$820,000 every year. The programme is likely to reduce direct disease-related costs to MOH by US$440,000 in the first year, increasing to US$510,000 by 2025. CONCLUSION: Introducing PCV13 as part of Mongolia’s national programme appears to be highly cost-effective when compared to no vaccination and cost-saving from a societal perspective at vaccine purchase prices offered through Gavi. Notwithstanding uncertainties around some parameters, cost-effectiveness of PCV introduction for Mongolia remains robust over a range of conservative scenarios. Availability of high-quality national data would improve future economic analyses for vaccine introduction.
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spelling pubmed-52973412017-02-16 Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia Sundaram, Neisha Chen, Cynthia Yoong, Joanne Luvsan, Munkh-Erdene Fox, Kimberley Sarankhuu, Amarzaya La Vincente, Sophie Jit, Mark Vaccine Article OBJECTIVE: The Ministry of Health (MOH), Mongolia, is considering introducing 13-valent pneumococcal conjugate vaccine (PCV13) in its national immunization programme to prevent the burden of disease caused by Streptococcus pneumoniae. This study evaluates the cost-effectiveness and budget impact of introducing PCV13 compared to no PCV vaccination in Mongolia. METHODS: The incremental cost-effectiveness ratio (ICER) of introducing PCV13 compared to no PCV vaccination was assessed using an age-stratified static multiple cohort model. The risk of various clinical presentations of pneumococcal disease (meningitis, pneumonia, non-meningitis non-pneumonia invasive pneumococcal disease and acute otitis media) at all ages for thirty birth cohorts was assessed. The analysis considered both health system and societal perspectives. A 3 + 0 vaccine schedule and price of US$3.30 per dose was assumed for the baseline scenario based on Gavi, the Vaccine Alliance’s advance market commitment tail price. RESULTS: The ICER of PCV13 introduction is estimated at US$52 per disability-adjusted life year (DALY) averted (health system perspective), and cost-saving (societal perspective). Although indirect effects of PCV have been well-documented, a conservative scenario that does not consider indirect effects estimated PCV13 introduction to cost US$79 per DALY averted (health system perspective), and US$19 per DALY averted (societal perspective). Vaccination with PCV13 is expected to cost around US$920,000 in 2016, and thereafter US$820,000 every year. The programme is likely to reduce direct disease-related costs to MOH by US$440,000 in the first year, increasing to US$510,000 by 2025. CONCLUSION: Introducing PCV13 as part of Mongolia’s national programme appears to be highly cost-effective when compared to no vaccination and cost-saving from a societal perspective at vaccine purchase prices offered through Gavi. Notwithstanding uncertainties around some parameters, cost-effectiveness of PCV introduction for Mongolia remains robust over a range of conservative scenarios. Availability of high-quality national data would improve future economic analyses for vaccine introduction. Elsevier Science 2017-02-15 /pmc/articles/PMC5297341/ /pubmed/28109706 http://dx.doi.org/10.1016/j.vaccine.2016.12.070 Text en © 2017 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sundaram, Neisha
Chen, Cynthia
Yoong, Joanne
Luvsan, Munkh-Erdene
Fox, Kimberley
Sarankhuu, Amarzaya
La Vincente, Sophie
Jit, Mark
Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
title Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
title_full Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
title_fullStr Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
title_full_unstemmed Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
title_short Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
title_sort cost-effectiveness of 13-valent pneumococcal conjugate vaccination in mongolia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297341/
https://www.ncbi.nlm.nih.gov/pubmed/28109706
http://dx.doi.org/10.1016/j.vaccine.2016.12.070
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