Huge impact of assumptions on indirect effects on the cost-effectiveness of routine infant vaccination with 7-valent conjugate vaccine (Prevnar^®)

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• 作者：Mark H. Rozenbaum ; Albert Jan van Hoek ; Eelko Hak ; Maarten J. Postma
• 关键词：Pneumococcal conjugate vaccine ; Vaccination ; PCV-7 ; Prevnar ; Cost-effectiveness ; Herd protection ; Economics ; S. pneumoniae ; Pneumococcus ; Serotype replacement
• 刊名：Vaccine
• 出版年：2010
• 出版时间：11 March 2010
• 年：2010
• 卷：28
• 期：12
• 页码：2367-2369
• 全文大小：160 K

文摘

Several recently published European cost-effectiveness studies on the 7-valent pneumococcal conjugate vaccine (PCV-7: Prevnar^®) have included net-indirect vaccine benefits for non-vaccine protected groups into their studies, which might be too optimistic an approach given recent data. Net-indirect effects result from herd protection minus serotype replacement effects. In this study we analyze the impact of net-indirect effects in non-vaccine protected groups of 5 years of age and older with updated assumptions regarding epidemiologic data and health care unit costs. Without net-indirect benefits for non-vaccine protected groups included the cost-effectiveness ratio is estimated at €72,360 per QALY. In order to obtain cost-effectiveness ratios below the threshold of €50,000 per QALY – which is in the middle of the range that is often referred to in the Netherlands – the net-indirect protective effect should at least be 16 % of which has been observed in the USA after the introduction of PCV-7.