Rodrigo Sini de Almeida, Brazil
Pfizer Inc. Medical VaccinesAuthor Of 2 Presentations
COST-EFFECTIVENESS AND BUDGET IMPACT OF SWITCHING FROM A LOWER TO A HIGHER VALENT PNEUMOCOCCAL CONJUGATE VACCINE IN BRAZIL (ID 238)
Abstract
Background
Brazil has a 10-valent pneumococcal conjugate vaccine (PCV10) pediatric national immunization program (NIP), even though a 13-valent (PCV13) is available and protects against three additional serotypes, 3, 6A, and 19A. Inadvertently, there has been emergence of PCV10 non-vaccine serotypes, notably 19A. We sought to evaluate the cost-effectiveness and budget impact of switching from PCV10 to PCV13 in 2019.
Methods
The analysis estimated future costs ($BRL), quality-adjusted life years (QALYs), and health outcomes for PCV10 and PCV13 NIPs over five years. The adapted model uses local Brazil serotype and Latin America incidence data from 2009-2018. Input parameters are from Brazilian sources. Future serotype dynamics is predicted using Brazilian and global historical trends (Figure 1).
Results
Over five years, switching from PCV10 to PCV13 prevents 176 thousand disease cases and 20 thousand deaths, gains 29 thousand QALYs, and saves 135 million direct and 3 million indirect costs. After one year, 16 million direct healthcare costs are saved by implementing a PCV13 NIP in Brazil.
Conclusions
Despite a higher PCV13 vaccine cost, a PCV13 NIP is cost-saving compared with PCV10, from both societal and payer perspectives. Brazil should consider switching to prevent disease burden, improve population health, and save immediate healthcare costs.
10-YEAR PUBLIC HEALTH IMPACT FROM 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) IN LATIN AMERICA (ID 240)
Abstract
Background
Pneumococcal conjugate vaccine (PCV) national immunization programs (NIPs) have effectively reduced vaccine serotype pneumococcal disease (PD) morbidity and mortality across Latin America (LatAm). In 2010, the 10-valent and 13-valen PCVs were introduced in routine alimentation. Given PCV13’s broader use and serotype coverage, we quantified its impact across LatAm.
Methods
We calculated the 10-year impact of pediatric PCV13 NIPs in LatAm by estimating PD cases averted and mortality prevented. A model was used to conduct the analysis for ages <5 in 14 LatAm countries that implemented PCV13 NIPs. Data were from reports by the United Nations, World Health Organization, and World Bank for parameters where available. Results are presented by country and aggregately.
Results
Approximately 39.4 million children have been vaccinated. Pediatric PCV13 vaccination translated into 13.7 million total pneumococcal disease cases averted (Table 1). Of the cases averted, 334 thousand were invasive pneumococcal disease, 2.2 million were pneumonia, and 11.2 million were otitis media. Moreover, 49.5 thousand estimated deaths were prevented.
Conclusions
The 10-year history of pediatric PCV13 NIPs in LatAm prevented millions of pneumococcal disease cases and thousands of deaths. However, the true public health impact is underestimated, as herd effects for non-vaccinated groups are not included in the calculations.