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.

摘要: Objectives In 2010, the 13-valent pneumococcal conjugate vaccine (PCV-13) replaced 7-valent (introduced in 2006) for vaccination against invasive diseases (IPDs), pneumonia and acute otitis media (AOM) UK. Using recent evidence on impact of PCVs epidemiological changes UK, we performed a cost-effectiveness analysis (CEA) to compare non-typeable Haemophilus influenzae protein D (PHiD-CV) with PCV-13 ongoing national programme. Design CEA was based published Markov model. The base-case scenario accounted only direct medical costs. Work days lost were considered alternative scenarios. Setting Calculations serotype disease-specific efficacies, distributions UK incidence rates Population Health benefits costs related IPD, AOM accumulated over lifetime birth cohort. Interventions Vaccination infants at 2, 4 12 months PHiD-CV or PCV-13, assuming complete coverage adherence. Outcome measures incremental ratio (ICER) computed by dividing difference between programmes quality-adjusted life-years (QALY). Results Under our model assumptions, both vaccines had similar IPD pneumonia, but generated greater reduction cases (161 918), AOM-related general practitioner consultations (31 070) tympanostomy tube placements (2399). At price parity, dominant saving 734 QALYs as well £3.68 million National Service (NHS). lower list PHiD-CV, cost-savings would increase £45.77 million. Conclusions This projected that provide health compared parity. could result substantial budget savings NHS. These be used implement other life-saving interventions.