Impact and cost effectiveness of pneumococcal conjugate vaccine in India
Autor: | Manikandanesan Sakthivel, Nayana P. Nair, Gokul Sarveswaran, Salin K. Eliyas, Yuvaraj Krishnamoorthy, Palanivel Chinnakali |
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Rok vydání: | 2018 |
Předmět: |
Cost effectiveness
Cost-Benefit Analysis 030231 tropical medicine India complex mixtures Pneumococcal conjugate vaccine Gross domestic product Pneumococcal Infections Decision Support Techniques Cohort Studies Pneumococcal Vaccines 03 medical and health sciences 0302 clinical medicine Environmental health Outpatients medicine Per capita Humans 030212 general & internal medicine health care economics and organizations Models Statistical Vaccines Conjugate General Veterinary General Immunology and Microbiology business.industry Immunization Programs Vaccination Public Health Environmental and Occupational Health Health Plan Implementation Cost-effectiveness analysis Health Care Costs Vaccine efficacy Hospitalization Infectious Diseases Molecular Medicine business Incremental cost-effectiveness ratio medicine.drug |
Zdroj: | Vaccine. 37(4) |
ISSN: | 1873-2518 |
Popis: | Background World Health Organization has recommended the introduction of pneumococcal conjugate vaccine (PCV) in the childhood immunisation programme of all the countries in the world. In lieu of its introduction in India, there is a need to generate evidence on cost-effectiveness of this vaccine. The current study looks into the impact and cost-effectiveness of PCV vaccine in India. Methods We evaluated the cost effectiveness of implementation of PCV 13 vaccination program at national level by comparing with no vaccination program for a period of 10 birth cohorts from 2018 to 2027. UNIVAC, a deterministic static cohort model is developed by giving the conservative estimates of vaccine program related to mortality, disease event rates, vaccine efficacy and coverage projections, system and health care costs for the first five years of life. Cost effectiveness is reported as Incremental Cost Effectiveness Ratio (ICER). Further scenario and sensitivity analysis were done. Probability of PCV intervention to be cost effective at a willingness to pay (WTP) threshold equal to per capita gross domestic product (GDP) is calculated using the government perspective. Results We found that the introduction of PCV vaccination program can cost an additional $467 (INR 31,666) for averting per DALY which is less than one time GDP per capita of India. Even with the most unfavourable scenario for PCV vaccine, cost per DALY averted is found to be $2323 (INR 1,57,520) which is still a cost effective intervention in India. Probabilistic sensitivity analysis found the ICER for PCV to be $649 (INR 44,008) with 95% CI: $374-$1161. Conclusion This study shows that the PCV program is a highly cost effective intervention and justifies the introduction of PCV into routine immunisation schedule in some of the states and recommends introducing it throughout the country to reduce morbidity and mortality among the under-five children. |
Databáze: | OpenAIRE |
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