773. Cost-Effectiveness Of The 13-Valent (PCV13) Versus 10-Valent (PCV10) Pneumococcal Conjugate Vaccines As Part Of Routine Infant Pneumococcal Vaccination In Mexico
Session: Poster Abstract Session: Vaccines: Pneumococcal
Thursday, October 27, 2016
Room: Poster Hall
Background:

Vaccination is an effective intervention to prevent the significant morbidity and mortality associated with pneumococcal disease. The objective of this study is to expand on a previously published cost-effectiveness analysis of immunization strategies based on PCVs in Mexico, by directly comparing the cost-effectiveness of PCV13 vs PCV10 and including the impact of indirect effects, local Mexican epidemiologic inputs and more recent cost data.

Methods:

A 1-year steady state decision analytic model was used to estimate lifetime costs and outcomes of vaccinating 85% of an annual birth cohort of 2.2 million Mexican infants in a number of scenarios from the institutional public payer perspective. Both vaccines were compared to no-vaccination and to one another in preventing cases and associated costs of invasive pneumococcal disease (IPD), community acquired pneumonia (CAP), and acute otitis media (AOM). Epidemiologic and economic inputs were derived from local Mexican surveillance data and the published literature. Costs and outcomes were discounted at a rate of 5%.

Results:

In the base case analysis PCV13 vaccination is projected to prevent more episodes and deaths, and is cost-saving compared to PCV10 (Table 1). Furthermore, PCV13 consistently provides the greatest public health impact and remains cost-saving vs. PCV10 across multiple scenarios including PCV10’s potential herd effect against IPD.

Table 1. Annual Impact of Pneumococcal Infant Vaccination

PCV13 vs No Vaccine

PCV10 vs No Vaccine

Difference

Direct effect+
 Herd effect
(IPD+CAP)

Direct effect
+ Herd Effect (IPD only)

Outcomes

Cases averted

78,581

27,612

50,969

IPD

515

206

309

Pneumonia

67,633

22,404

45,229

AOM

10,434

5,002

5,431

Deaths averted

2,000

196

1,804

QALYs saved

35,700

6,415

29,285

Net cost ($USD)

-74.81 million

13.89 million

-88.71 million

ICER

PCV13 is Cost-saving

Conclusion:

A National Immunization Program (NIP) with PCVs would continue to have a remarkable public health impact in Mexico. Use of PCV13 would maximize reductions in cases, death, and be cost-saving compared with PCV10. Sustained funding for NIP may be warranted.

Matt Wasserman, MSc1, Carlos Fernando Mendoza, Pharm D. MSc2, Ana Gabriela Grajales, MD2, Maria Gabriela Palacios, MD2 and Manuela Di Fusco, B.Ec, MSc2, (1)Pfizer, New York, NY, (2)Pfizer, Mexico City, Mexico

Disclosures:

M. Wasserman, Pfizer: Employee , Salary

C. F. Mendoza, Pfizer: Employee , Salary

A. G. Grajales, Pfizer: Employee , Salary

M. G. Palacios, Pfizer: Employee , Salary

M. Di Fusco, Pfizer: Employee , Salary

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