1. Cost-effectiveness of 13-valent pneumococcal conjugate vaccination in Mongolia
- Author
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Mark Jit, Munkh-Erdene Luvsan, Cynthia Chen, Joanne Yoong, Sophie La Vincente, Kimberley Fox, Amarzaya Sarankhuu, and Neisha Sundaram
- Subjects
Male ,Cost effectiveness ,Cost-Benefit Analysis ,PCV13 ,medicine.disease_cause ,MOH, Ministry of Health ,Pneumococcal conjugate vaccine ,PCV, pneumococcal conjugate vaccine ,Pneumococcal Vaccines ,0302 clinical medicine ,030212 general & internal medicine ,PAHO, Pan American Health Organization ,health care economics and organizations ,AOM, acute otitis media ,ICER, incremental cost-effectiveness ratio ,Budget impact ,GNI, gross national income ,Vaccination ,Pneumococcal infections ,Infectious Diseases ,Streptococcus pneumoniae ,AMC, advance market commitment ,Child, Preschool ,Molecular Medicine ,Female ,Quality-Adjusted Life Years ,medicine.drug ,complex mixtures ,Mass Vaccination ,Article ,Pneumococcal Infections ,DALY, disability-adjusted life year ,03 medical and health sciences ,030225 pediatrics ,Environmental health ,Immunology and Microbiology(all) ,medicine ,Humans ,NPNM, non-pneumonia non-meningitis ,Immunization Schedule ,Models, Statistical ,Vaccines, Conjugate ,General Veterinary ,General Immunology and Microbiology ,CFR, case-fatality risk ,business.industry ,Immunization Programs ,GDP, gross domestic product ,Public Health, Environmental and Occupational Health ,WPR, Western Pacific region ,Infant ,Mongolia ,medicine.disease ,veterinary(all) ,MNT, Mongolian tugrik ,Quality-adjusted life year ,OOP, out-of-pocket ,Immunization ,Immunology ,Cost-effectiveness ,business ,Hib, haemophilus influenzae type b ,Vaccine ,IPD, invasive pneumococcal disease - Abstract
OBJECTIVE: The Ministry of Health (MOH), Mongolia, is considering introducing 13-valent pneumococcal conjugate vaccine (PCV13) in its national immunization programme to prevent the burden of disease caused by Streptococcus pneumoniae. This study evaluates the cost-effectiveness and budget impact of introducing PCV13 compared to no PCV vaccination in Mongolia. METHODS: The incremental cost-effectiveness ratio (ICER) of introducing PCV13 compared to no PCV vaccination was assessed using an age-stratified static multiple cohort model. The risk of various clinical presentations of pneumococcal disease (meningitis, pneumonia, non-meningitis non-pneumonia invasive pneumococcal disease and acute otitis media) at all ages for thirty birth cohorts was assessed. The analysis considered both health system and societal perspectives. A 3+0 vaccine schedule and price of US$3.30 per dose was assumed for the baseline scenario based on Gavi, the Vaccine Alliance's advance market commitment tail price. RESULTS: The ICER of PCV13 introduction is estimated at US$52 per disability-adjusted life year (DALY) averted (health system perspective), and cost-saving (societal perspective). Although indirect effects of PCV have been well-documented, a conservative scenario that does not consider indirect effects estimated PCV13 introduction to cost US$79 per DALY averted (health system perspective), and US$19 per DALY averted (societal perspective). Vaccination with PCV13 is expected to cost around US$920,000 in 2016, and thereafter US$820,000 every year. The programme is likely to reduce direct disease-related costs to MOH by US$440,000 in the first year, increasing to US$510,000 by 2025. CONCLUSION: Introducing PCV13 as part of Mongolia's national programme appears to be highly cost-effective when compared to no vaccination and cost-saving from a societal perspective at vaccine purchase prices offered through Gavi. Notwithstanding uncertainties around some parameters, cost-effectiveness of PCV introduction for Mongolia remains robust over a range of conservative scenarios. Availability of high-quality national data would improve future economic analyses for vaccine introduction.
- Published
- 2017