Cost-effectiveness evaluation of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vacc
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Cost Effectiveness and Resource Allocation Open Access
RESEARCH
Cost‑effectiveness evaluation of the 10‑valent pneumococcal non‑typeable Haemophilus influenzae protein D conjugate vaccine for children in Taiwan Chun‑Yi Lu1, Ching‑Hu Chung2, Li‑Min Huang1, Eliza Kruger3, Seng‑Chuen Tan3, Xu‑Hao Zhang4 and Nan‑Chang Chiu2,5*
Abstract Background: Streptococcus pneumoniae (S. pneumoniae) and non-typeable Haemophilus influenzae (NTHi) are sub‑ stantial contributors to morbidity and mortality of diseases including invasive pneumococcal diseases (IPDs), pneu‑ monia and acute otitis media (AOM) worldwide. In Taiwan, 10-valent pneumococcal polysaccharide and NTHi protein D conjugate vaccine (PHiD-CV) and 13-valent pneumococcal conjugate vaccine (PCV13) are licensed in children against pneumococcal disease. In addition to S. pneumoniae, clinical trials suggest efficacy of PHiD-CV against NTHi AOM. This study aims at evaluating the cost-effectiveness of a 2 + 1 schedule of PHiD-CV vs. PCV13 2 + 1 in the univer‑ sal mass vaccination program of infants in Taiwan. Methods: A published Markov cohort model was adapted to simulate the epidemiological burden of IPD, pneu‑ monia and AOM for a birth cohort in Taiwan over 10 years. The probability of entering a specific health state was based on the incidence rate of the diseases. Only direct medical costs were included, and costs and outcomes were discounted annually. Vaccine efficacy assumptions were based on published data and validated by a panel of independent experts. Clinical, epidemiological, and serotype distribution data were based on locally published data or the National Health Insurance Research Database. Price parity of vaccines was assumed. Published pneumococ‑ cal disease-related disutility weights were used due to lack of local data. Incremental cost-effectiveness ratio was calculated and benchmarked against the recommended threshold in Taiwan. Extensive one-way sensitivity analysis, alternative scenarios and probabilistic sensitivity analysis were performed to test the robustness of the results. Results: PHiD-CV would potentially reduce the number of NTHi-related AOM cases substantially and prevent compa‑ rable IPD and pneumonia-related cases and deaths compared to PCV13. Over a 10-year horizon, PHiD-CV is estimated to dominate PCV13, saving 6.7 million New Taiwan Dollars (NTD) and saving 21 quality-adjusted life years. The result was robust over a wide range of sensitivity analyses. The dominance of PHiD-CV was demonstrated in 90.5% of the simulations. Conclusions: PHiD-CV 2 + 1 would provide comparable prevention of IPD, pneumonia cases and additional reduc‑ tion of NTHi-AOM cases, and is considered dominant compared with PCV13 2 + 1 in Taiwan.
*Correspondence: [email protected] 5 Mackay Children’s Hospital, No. 92, Sec. 2, Zhongshan N. Rd, Taipei City 10449, Taiwan Full list of author information is available at the end of the article © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits
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