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Published on: February 15, 2013
Public Health Value of a Hypothetical Pneumococcal Conjugate Vaccine (PCV) Introduction: A Case Study
Nathorn Chaiyakunapruk1,2, Dayoung Song3, Julia Lynch4
1Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT 84112, USA.
Insights
Introducing the 12-valent pneumococcal conjugate vaccine (PCV12) in Thailand is a cost-saving strategy. This new vaccine is projected to avert thousands of pneumococcal disease cases, demonstrating significant public health value.
Area of Science:
- Health Economics and Outcomes Research
- Vaccine Policy and Implementation Science
- Infectious Disease Epidemiology
Background:
- Early assessment of vaccine public health value is crucial for investment prioritization.
- Pneumococcal conjugate vaccines (PCVs) significantly reduce childhood disease burden.
- Thailand's national immunization program is a key setting for evaluating new vaccine introductions.
Purpose of the Study:
- To evaluate the potential cost-effectiveness of introducing a 12-valent pneumococcal conjugate vaccine (PCV12) in Thailand.
- To compare PCV12 against no vaccination, PCV10, and PCV13 from a societal perspective.
- To determine the economic impact and health gains associated with PCV12 implementation.
Main Methods:
- A hypothetical cost-effectiveness analysis using a 2+1 regimen for PCV12 introduction.
- Modeling included a lifetime horizon with a one-year cycle length, incorporating Thai data and literature-based assumptions.
- One-way sensitivity analysis was performed on the PCV12 price (0.5-1.5 times base price); results presented as ICER per QALY gained.
Main Results:
- PCV12 vaccination is projected to avert 5358 cases per 100,000 children, including meningitis, bacteremia, pneumonia, and otitis media.
- The national PCV12 vaccination program is a cost-saving strategy compared to no PCV, PCV10, and PCV13.
- PCV12 remains cost-saving even when its price is 1.5 times the base price, according to sensitivity analysis.
Conclusions:
- The study indicates substantial potential public health value for PCV12 in Thailand.
- PCV12 demonstrates strong economic value, presenting as a cost-saving intervention.
- Findings support the consideration of PCV12 for inclusion in Thailand's national immunization program.
Abstract:
Background: Understanding the public health value of a vaccine at an early stage of development helps in valuing and prioritizing the investment needed. Here we present the potential cost-effectiveness of an upcoming 12 valent pneumococcal conjugate vaccine (PCV 12) in the case study country, Thailand. Methods: The cost-effectiveness analysis included a hypothetical scenario of three doses (2 + 1 regimen) PCV12 introduction in the national immunization program of Thailand compared to no PCV, PCV10, and PCV13 among <6 months old from a societal perspective with a lifetime horizon and one-year cycle length. Data from Thailand, as well as assumptions supported by the literature, were used in the analysis. The price of PCV12 was assumed similar to that of PCV10 or PCV13 for GAVI’s eligible countries based on inputs from stakeholder meeting. A one-way sensitivity analysis was conducted using 0.5−1.5 times the base price of PCV12. Results were presented in incremental cost-effectiveness ratio (ICER) in terms of monetary value per quality-adjusted life-year (QALY) gained. Results: Vaccination with PCV12 among a hypothetical cohort of 100,000 Thai children is expected to avert a total of 5358 cases which includes 5 pneumococcal meningitis, 43 pneumococcal bacteremia, 5144 all-cause pneumonia, and 166 all-cause acute otitis media compared to no vaccination. The national PCV12 vaccination program is a cost-saving strategy compared to the other three strategies. The one-way sensitivity analysis showed PCV12 is a cost-saving strategy when 1.5 times the base price of PCV12 was assumed. Conclusions: Within the limitations of hypothetical assumptions and price points incorporated, the study indicates the potential public health value of PCV12 in Thailand.
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