G1-2090. Cost -Effectiveness of Universal Pneumococcal Vaccination of Infants in Argentina: Assessing Three Additional Scenarios
Session: Poster Session: Pneumococcal Vaccines: Pediatrics
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: Pneumococcal infections are a major cause of illness. Objective:Evaluate the cost-effectiveness of the 7-valent pneumococcal conjugate vaccination (PCV-7) for children aged < 5 years in Argentina. Methods: A Markov model simulated lifetime evolution of a birth cohort (n 696451). As a base case analysis, we established a universal four-dose vaccination scheme of 5 years long protection period. Three additional scenarios were considered: herd immunity (HI), effectiveness, and 3 doses vaccination scheme. The efficacy and effectiveness of the vaccine were assumed as observed in USA clinical trials and Medical Care Survey respectively and adjusted for Argentina serotype prevalence.HI was included using a statical model.Utility assessments were obtained from local data of Time Trade-off experience.The results were expressed as incremental cost in 2007 US dollars per life years (LY) and quality adjusted life years (QALY) gained. Results: In the base case analysis, the incremental cost per LY gained was 10226.71 $ and 6618.92 $ per QALY from the societal perspective. The model estimated that vaccination would reduce the number of deaths by 91, pneumococcal meningitis by 76, pneumococcal bacteremia by 798, pneumonia by 4145, and otitis by 122255 episodes.When HI was included, the cost per LY gained was 8810.97 $. Effectiveness impact of the vaccine was 3585.37 $ per LY gained and 2431.83 $ per QALY. Universal three-dose scheme cost was 6474.55 $ per LY gained and 4190.45$ per QALY. The model shows moderate sensitivity to variations regarding efficacy, cost of the vaccine and mortality rates due to pneumonia. Conclusions: Using a benchmark of 3 times per capita gross national income as the threshold for cost-effective intervention, PCV-7 vaccination is cost-effective in the base case analysis and highly cost effective considering HI, effectiveness and three-dose
Alejandro Cane, MD, Vaccines, Pfizer Vaccines Latin America, Buenos Aires, Argentina, Angela Gentile, MD, R. Gutierrez, Children's Hospital, Buenos Aires, Argentina, Norberto Giglio, MD, Hospital de Niņos Ricardo Gutierrez, Buenos Aires, Argentina, Paula Micone, Medical Doctor, Austral University and  N. Giglio,
Wyeth S.A. Role(s): Investigator, Received: Educational Grant.