Cost-utility and cost-benefit analysis of pediatric PCV programs in Egypt

Area of Science:

• Health economics
• Vaccinology
• Public health policy

Background:

• New vaccine introductions (NVIs) present value for money (VfM) challenges for middle-income countries.
• Egypt, as a self-financing nation, requires robust economic evaluations for vaccine adoption.
• Pneumococcal conjugate vaccines (PCVs) are critical for reducing childhood illness and mortality.

Purpose of the Study:

• To evaluate the value for money (VfM) of introducing the 13-valent pneumococcal conjugate vaccine (PCV13) in Egypt.
• To compare PCV13 and the 10-valent PCV (PCV10) from both health payer and societal perspectives.
• To assess the cost-utility and cost-benefit of these new vaccine introductions (NVIs).

Main Methods:

• Cost-utility analysis (CUA) and cost-benefit analysis (CBA) were employed.
• Health effects were modeled using disease incidence projection and static disease models.
• A health-augmented lifecycle model was used for CBA, calculating rates of return (RoR).

Main Results:

• Base-case CUA showed incremental cost-effectiveness ratios (ICERs) per QALY for PCV13 and PCV10 vs. no vaccination as $926 and $1,984, respectively.
• PCV13 demonstrated a superior ICER vs. PCV10 at $174 per QALY.
• Base-case CBA revealed high RoRs: PCV13 (488%) and PCV10 (164%) vs. no vaccination; PCV13 vs. PCV10 showed a 3109% RoR.

Conclusions:

• Both CUA and CBA indicate that PCV13 offers superior value for money compared to PCV10 in Egypt.
• The introduction of PCV13 is a cost-effective strategy, yielding substantial health gains and economic benefits.
• Findings support the adoption of PCV13 for Egypt's national immunization program.