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
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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