Cost-effectiveness analysis of pneumococcal conjugate vaccine 13-valent in older adults in Colombia.

Jaime E Ordóñez,John J Orozco

doi:10.1186/1471-2334-14-172

Jaime E Ordóñez, John J Orozco

Open Access

https://doi.org/10.1186/1471-2334-14-172

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Abstract

BackgroundNowadays, there are two vaccination strategies in Colombia to prevent pneumococcal diseases in people over 50 years. Our aim is to estimate cost-effectiveness of pneumococcal conjugate vaccine 13-valent (PCV13) versus pneumococcal polysaccharide vaccine 23-valent (PPSV23) to prevent pneumococcal diseases and their related mortality in people over 50 years old in Colombia.MethodsA Markov model was developed with national data, including pneumococcal serotypes distribution in Colombia between 2005 and 2010. Vaccination of a cohort was simulated and a five year time horizon was assumed. Analysis was done from a perspective of a third party payer. Direct costs were provided by a national insurance company; sensitive univariate and probabilistic analysis were done for epidemiological and clinical effectiveness parameters and costs.ResultsPCV13 avoids 3 560 deaths by pneumococcal infections versus PPSV23 and 4 255 deaths versus no vaccine. PCV13 prevents 79 633 cases by all-cause pneumonia versus PPSV23 and 81 468 cases versus no vaccine. Total costs (healthcare and vaccines costs) with PCV13 would be U.S. $ 97,587,113 cheaper than PPSV23 and it would save U.S. $ 145,196,578 versus no vaccine.ConclusionPCV13 would be a cost-saving strategy in the context of a mass vaccination program in Colombia to people over 50 years old because it would reduce burden of disease and specific mortality by pneumococcal diseases, besides, it saves money versus PPSV23.

Highlights

Nowadays, there are two vaccination strategies in Colombia to prevent pneumococcal diseases in people over 50 years
Model A cost-effectiveness analysis was performed using a Markov model with a first-order microsimulation to determine the risk of developing Invasive Pneumococcal Disease (IPD) and pneumonia in people over 50 years; the original model was developed by PAI (Policy Analysis Inc.) to Pfizer
Risk reduction associated with the vaccines relied on the clinical presentation of diseases: IPD, inpatient pneumonia or outpatient pneumonia; as well as the vaccine, time since vaccination, age at time of diseases, and risk profile [20] (Figure 1) Further methodologic details can be referenced from application of the model to the US setting [20]

Summary

Introduction

There are two vaccination strategies in Colombia to prevent pneumococcal diseases in people over 50 years. Our aim is to estimate cost-effectiveness of pneumococcal conjugate vaccine 13-valent (PCV13) versus pneumococcal polysaccharide vaccine 23-valent (PPSV23) to prevent pneumococcal diseases and their related mortality in people over 50 years old in Colombia. Given the burden of disease by pneumococcal diseases in worldwide, a prevention strategy with vaccination may be the most cost-effective approach to health systems. This is not a new topic, there are randomized clinical trials (RCTs) from 1940s [12,13], but it was just until 1977 that began the widespread use of this technology, when pneumococcal polysaccharide 14-valent vaccine (PPSV14)

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