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An updated cost-effectiveness analysis of pneumococcal conjugate vaccine among children in Thailand

Piyameth Dilokthornsakul1, Kirati Kengkla2, Surasak Saokaew3

  • 1Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.

Vaccine
|July 9, 2019
PubMed

Insights

Pneumococcal conjugate vaccines (PCV10 and PCV13) are cost-effective for children in Thailand, especially when considering herd effects. PCV13 demonstrates strong cost-effectiveness at current prices, while PCV10 becomes cost-effective with herd immunity benefits.

Area of Science:

  • Public Health
  • Health Economics
  • Vaccinology

Background:

  • Previous analyses indicated PCV10 and PCV13 were not cost-effective for universal childhood immunization in Thailand.
  • Recent shifts in vaccine efficacy, herd effects, and pricing necessitate a re-evaluation of PCV cost-effectiveness.
  • This study revisits the cost-effectiveness of PCV10 and PCV13 in the Thai pediatric population.

Purpose of the Study:

  • To determine the cost-effectiveness of Pneumococcal Conjugate Vaccine 10 (PCV10) and Pneumococcal Conjugate Vaccine 13 (PCV13) compared to no vaccination in Thai children.
  • To update previous cost-effectiveness analyses (CEA) based on current evidence and pricing.
  • To inform vaccination policy decisions in Thailand regarding pneumococcal immunization.

Main Methods:

  • A Markov model was employed from a societal perspective with a lifetime horizon.
  • Data were sourced from literature reviews and the Thai National Electronic Database, with costs adjusted to 2017 values.
  • Incremental Cost-Effectiveness Ratios (ICERs) were calculated in Thai Baht (THB) per Quality-Adjusted Life Year (QALY) gained, with a 3% discount rate.

Main Results:

  • Without herd effects, PCV10's ICER was 170,437 THB/QALY, and PCV13's was 73,674 THB/QALY.
  • Including herd effects, both PCV10 and PCV13 demonstrated lower costs and higher QALYs compared to no vaccination.
  • Probabilistic sensitivity analysis indicated PCV13 had a 93% probability of cost-effectiveness at a willingness-to-pay threshold of 160,000 THB/QALY.

Conclusions:

  • At current prices, PCV13 is cost-effective for Thai children, whereas PCV10 is not.
  • When herd effects are considered, both PCV10 and PCV13 become cost-effective interventions.
  • The findings support the inclusion of PCV13 in Thailand's national immunization program based on economic value.
Abstract

Keywords:
Cost-effectiveness analysisPneumococcal conjugate vaccineThailand

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