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Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies
Neily Zakiyah1,2, Widya N Insani1,2,3, Auliya A Suwantika1,2,4
1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Bandung 40132, Indonesia.
Insights
Pneumococcal conjugate vaccine (PCV) programs for children are cost-effective in Asia, often saving costs. Key factors influencing this include vaccine price, pneumonia burden, and herd effects.
Area of Science:
- Public Health
- Health Economics
- Vaccinology
Background:
- Limited evidence exists on the cost-effectiveness of pneumococcal conjugate vaccines (PCVs) for children in Asian countries.
- Asia faces a significant burden of pneumococcal disease, necessitating an overview of PCV implementation costs and benefits.
Purpose of the Study:
- To conduct a systematic review of economic evaluations of PCV for children in Asian countries.
- To provide a comprehensive overview of the cost-effectiveness of PCV vaccination programs in the region.
Main Methods:
- Systematic literature review of studies published up to May 2020, sourced from PubMed and Embase.
- Data extraction focused on study characteristics, parameters, costs, cost-effectiveness results, and uncertainty drivers.
- Adherence to PRISMA guidelines for systematic reviews and CHEERS for reporting quality assessment.
Main Results:
- Twenty-five studies met the inclusion criteria, indicating PCV is cost-effective in most of Asia and cost-saving in some nations.
- Cost-utility analysis (CUA) using Quality-Adjusted Life Years (QALYs) or Disability-Adjusted Life Years (DALYs) was commonly employed.
- Vaccine price, pneumonia burden, and herd effects were identified as primary drivers of cost-effectiveness.
Conclusions:
- Pneumococcal vaccination programs for children are generally cost-effective in Asia, with potential for cost savings.
- Vaccine price, disease burden, and herd effects significantly influence cost-effectiveness estimations.
- Integrating PCV into existing vaccination strategies in Asia is a highly favorable intervention.
Abstract:
Background: Evidence on costs and health benefits of pneumococcal conjugate vaccine (PCV) for children in Asian countries is limited but growing. As a region with a considerably high burden of pneumococcal disease, it is prominent to have a comprehensive overview on the cost-effectiveness of implementing and adopting a PCV vaccination program. Methods: We conducted a systematic review from Pubmed and Embase to identify economic evaluation studies of PCV for children in Asian countries up to May 2020. Data extraction included specific characteristics of the study, input parameters, cost elements, cost-effectiveness results, and key drivers of uncertainty. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement was followed for this systematic review. The reporting quality of the included studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results: After the screening process on both the title and abstract and full text of 518 records, a total of 25 studies fulfilled the inclusion criteria, and were included in the review. The majority of included studies demonstrates that PCV for children is cost-effective in most of the Asian region, and even cost-saving in some countries. Most of the included studies implemented cost utility analysis (CUA) using either quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Overall, the main drivers affecting the cost effectiveness were vaccine price, burden regarding pneumonia-related parameters, and the inclusion of herd effects. Conclusion: The children pneumococcal vaccination program appears to be a cost-effective intervention in Asia, and even cost-saving in certain conditions. Vaccine price, pneumonia-related disease burden, and the inclusion of the herd effect are observed as important key drivers in estimating cost-effectiveness in this region. Incorporating PCV in vaccination programs in this region was found to be highly favorable.
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