Cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban national immunization programme.

Autor:	García Fariñas A; Finlay Vaccine Institute, Havana, Cuba. Electronic address: agfarinas@finlay.edu.cu., Linares-Pérez N; Finlay Vaccine Institute, Havana, Cuba., Clark A; London School of Hygiene & Tropical Medicine, London, United Kingdom., Toledo-Romaní ME; Institute of Tropical Medicine Pedro Kouri, Havana, Cuba., Omeiri NE; Pan American Health Organization, Washington, D.C., USA., Marrero Araújo MC; National School of Public Health, Havana, Cuba., Gonzálvez Luis IP; Finlay Vaccine Institute, Havana, Cuba., Toraño Peraza G; London School of Hygiene & Tropical Medicine, London, United Kingdom., Reyes Jiménez A; London School of Hygiene & Tropical Medicine, London, United Kingdom., López Ambrón L; Ministry of Public Health, Havana, Cuba.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2020 Aug; Vol. 97, pp. 182-189. Date of Electronic Publication: 2020 May 29.
DOI:	10.1016/j.ijid.2020.05.078
Abstrakt:	Objectives: To evaluate the cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban National Immunization Program (NIP). Methods: We compared PCV7-TT given at two, four and six months of age to a scenario without PCV7-TT, over a ten-year period (2020-2029). We calculated the cost (Cuban pesos - CUP) per Disability Adjusted Life Year (DALY) averted from a Government perspective. We compared results from a static cohort model and a parsimonious prediction model informed by the serotype distribution among pneumococcal carriers and cases. We ran probabilistic and deterministic uncertainty analyses. Results: PCV7-TT could prevent 6897 (95% uncertainty interval, 4344-8750) hospitalizations and 189 (115-253) deaths in children <5 years of age, over the period 2020-2029. This could cost around 25 million (20-31) discounted CUP but would be offset by treatment cost savings of around 23 million (14-31). A parsimonious model predicted less favourable impact and cost-effectiveness but the cost per DALY averted was still less than 0.4 times the current GDP per capita. Conclusions: PCV7-TT is likely to be cost-effective in Cuba. The impact of the vaccine would need to be carefully monitored following its introduction into the NIP. (Copyright © 2020. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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