The objective of this study was to evaluate the health outcomes, costs, and cost-effectiveness of vaccination with PCV-7, compared with no vaccination for children in Spain.
A health state model was used to determine the health and economic outcomes in vaccinated and unvaccinated groups among children less than 5 years old. This analysis was conducted for a 10-year time horizon, beginning with initial vaccinations. Information on the burden of pneumococcal disease, in terms of data on the incidence and seroprevalence of disease, was collected from published and unpublished records, supplemented, and verified by Spanish pediatric and infectious disease experts. The efficacy of PCV-7 was based on updated findings of the Kaiser Permanente Efficacy Study. A cost-of-illness estimate for each pneumococcal disease was determined using decision tree analysis that considered direct and indirect costs. A birth cohort analysis compared the expected cost of vaccinated populations to age-matched unvaccinated populations.
Implementing a PCV-7 vaccine program in Spain in a birth cohort of 360,000 is expected to save approximately 16 lives and 132,000 cases of pneumococcal disease over 10 years, resulting in total savings estimated at ?1 million (ESP13.5 billion), of which ?3.5 million (ESP7.1 billion) are direct medical savings. At a vaccine cost up to ?6.87 per dose (ESP9,462, the total cost of vaccinating a birth cohort of 360,000 will be offset by the total savings owing to reduced morbidity.
Implementing a universal PCV-7 vaccination program in Spain will significantly decrease the mortality and morbidity associated with pneumococcal infections in young children. At an assumed cost of ?8.56 (ESP8,080) per dose, PCV-7 vaccination of Spanish children under the age of 5, followed over a 10-year period, is cost saving from the societal perspective and cost-effective from the payer perspective at ?2,500 per LYG (ESP3,734,713), comparing favorably with other preventive programs in Spain.