Cost-Effectiveness of the 13-Valent Pneumococcal Conjugate Vaccine (PCV) Versus 10-Valent PCVs in Filipino Infants. (March 2022)

• Record Type: Journal Article
• Authors: Perdrizet, J.; Horn, E.; Nua, W.; Peralta, J. Perez; Nailes, J.; Santos, J.; Ong-Lim, A.
• Is Part Of: International journal of infectious diseases. Volume 116(2022)Supplement
• Page Start: S118
• Publication Date: 2022-03
• Subjects: Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.12.278
• Languages: English
• ISSNs: 1201-9712

Abstract

Abstract : Purpose: In the Philippines, uptake of the 13-valent pneumococcal conjugate vaccine (PCV13) has remained relatively low despite its inclusion in the pediatric national immunization program (NIP) since 2015. The objective of this study is to determine whether PCV13 or 10-valent PCVs manufactured by GlaxoSmithKline (PCV10-GSK) or Serum Institute of India (PCV10-SII) provide better value for money when increasing vaccine uptake among Filipino infants nationally. Methods & Materials: A decision-analytic model was adapted to estimate the public health and economic impact of continued use of PCV13 compared with a switch to either PCV10-GSK or PCV10-SII with 90% PCV uptake in the Philippines NIP. Clinical and economic input parameters were sourced from published literature. Future disease is forecasted using historical age- and serotype-specific surveillance data. Total cases of invasive pneumococcal disease, pneumonia, and acute otitis media, pneumococcal deaths, direct and indirect healthcare costs, and quality-adjusted life years (QALYs) gained were discounted 7% annually and modeled for each PCV. Given clinical uncertainty of this newly registered PCV, PCV10-SII outcomes were reported as ranges. Incremental cost-effectiveness ratios (ICERs) are calculated for PCV13 versus lower-valent PCVs (PCV10-GSK or PCV10-SII) from a societal perspective over 10 years. Results: Continuing PCV13 use is estimated to avert 375, 831 more pneumococcal disease cases, save 53, 189 additional lives, and gain 153, 349 QALYs compared with switching to PCV10-GSK over 10 years. Accounting for vaccine costs, this equates to cost savings of PHP 12.27 billion. Similarly, maintaining PCV13 has a greater clinical impact and is more cost-saving compared with switching to PCV10-SII. A NIP with PCV10-SII would result in more disease cases (313, 797-666, 889), more deaths (22, 759 - 72, 435), and lost QALYs (108, 061 - 266, 108), equating to a net economic loss (PHP 359.82 million - PHP 14.41 billion). Conclusion: PCV13 vaccination is estimated to not only prevent additional pneumococcal disease cases and deaths than PCV10-GSK or PCV10-SII, but also would provide greater cost-savings over 10 years compared to either 10-valent vaccines. Maintaining a PCV13 NIP would provide good value for money and would be the most affordable option to achieve universal PCV coverage in the Philippines.