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Abstract
Objectives In 2010, the 13-valent pneumococcal conjugate vaccine (PCV-13) replaced the 7-valent vaccine (introduced in 2006) for vaccination against invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) in the UK. Using recent evidence on the impact of PCVs and epidemiological changes in the UK, we performed a cost-effectiveness analysis (CEA) to compare the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) with PCV-13 in the ongoing national vaccination programme.
Design CEA was based on a published Markov model. The base-case scenario accounted only for direct medical costs. Work days lost were considered in alternative scenarios.
Setting Calculations were based on serotype and disease-specific vaccine efficacies, serotype distributions and UK incidence rates and medical costs.
Population Health benefits and costs related to IPD, pneumonia and AOM were accumulated over the lifetime of a UK birth cohort.
Interventions Vaccination of infants at 2, 4 and 12 months with PHiD-CV or PCV-13, assuming complete coverage and adherence.
Outcome measures The incremental cost-effectiveness ratio (ICER) was computed by dividing the difference in costs between the programmes by the difference in quality-adjusted life-years (QALY).
Results Under our model assumptions, both vaccines had a similar impact on IPD and pneumonia, but PHiD-CV generated a greater reduction in AOM cases (161 918), AOM-related general practitioner consultations (31 070) and tympanostomy tube placements (2399). At price parity, PHiD-CV vaccination was dominant over PCV-13, saving 734 QALYs as well as £3.68 million to the National Health Service (NHS). At the lower list price of PHiD-CV, the cost-savings would increase to £45.77 million.
Conclusions This model projected that PHiD-CV would provide both incremental health benefits and cost-savings compared with PCV-13 at price parity. Using PHiD-CV could result in substantial budget savings to the NHS. These savings could be used to implement other life-saving interventions.
- HEALTH ECONOMICS
- IMMUNOLOGY
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Footnotes
Contributors ED provided substantial scientific input to the study and study report, critically reviewed the study report, and was involved in study and economic modelling development, populating models and determination of model settings, acquisition of data, determination of the model inputs and statistical data analysis. OL provided substantial scientific input to the study and study report, critically reviewed the study report, and was involved in method selection and development, economic modelling development, data mining and literature review, populating models and determination of model settings, acquisition of data, model inputs and assessment of robustness of results (sensitivity analysis). ET participated in the selection of model inputs and the acquisition of data. NVdV provided substantial scientific input to the study and study report, critically reviewed the study report, was involved in the method selection, development and determination of model settings, and participated in the development of the economic modelling and the sensitivity analysis. All authors provided intellectual contributions to this manuscript, critically reviewed the manuscript and have approved the final version.
Funding GlaxoSmithKline Biologicals SA funded this study and all costs associated with the development and the publishing of this present manuscript (internal GSK identifier: HO-12-8103).
Disclaimer Synflorix is a trade mark of the GSK group of companies.
Competing interests ED is an employee of the GSK group of companies and reports ownership of restricted shares from the GSK group of companies; OL reports that (A) he was an external consultant and received payment on a contract basis from the GSK group of companies at the time of the study and (B) is married to a previous employee of the GSK group of companies owning restricted shares from the GSK group of companies; ET is an employee of the GSK group of companies; NVdV is an employee of the GSK group of companies and reports ownership of restricted shares from the GSK group of companies.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data used in this study are presented in the manuscript and the supplementary files, or references to the original material are provided. Please contact the corresponding author shall you require any additional information.