PIN64 Cost-Effectiveness Analysis of Anti-Pneumococcal Vaccines in Guatemala

Abstract

. Pneumococcal bacteremia and pneumonia are priority diseases for public health in Guatemala since these are among the 10 most frequent causes of hospitalizations and mortality in children under 4 years old. The aim of this study was to estimate the cost-effectiveness of immunization strategies based on pneumococcal conjugate vaccines (PCVs) in Guatemala, from an institutional perspective. . A decision tree steady state model was used to assess the population level public health and economic impact of infant anti-pneumococcal vaccination. The alternatives compared were: no vaccination (comparator), PCV-10 and PCV-13. The effectiveness measures were: illness avoided life years gained (LYs) and quality-adjusted life years (QALYs) gained. Effectiveness and utilities were obtained from literature. Local costs (expressed in 2011 $US) and epidemiology (data from 2009-2011) were obtained from Guatemala′s official databases. Univariate sensitivity analysis was performed. The time horizon for total costs was one year and for outcomes was lifetime with a discount rate of 3%. . Results show that immunization is cost-saving against no-vaccination. PCV-13 gained more QALYs (7,569) against PCV-10 (5,824). PCV-13 prevented 5658 illnesses and gained 8404 LYs, while PCV-10 prevented 4140 illnesses and gained 6465 LYs. Total costs of illness with PCV-13, PCV-10 and no vaccination were $2,599,952, $3,071,811 and $5,534,657, respectively. These results were robust to variations in herd immunity and impact adjustments of PCV-10 immunogenicity. . This is the first cost-effectiveness study for anti-pneumococcal immunization developed in Guatemala. Immunization strategies based on 10 and 13-valent PCV′s may be cost-saving interventions. PCV-13 dominates PCV-10.