Economic evaluation of a universal childhood pneumococcal conjugate vaccination strategy in Ireland

Abstract

Objective: To evaluate the cost-effectiveness of implementing a universal infant 7-valent pneumococcal conjugate vaccine (PCV7) vaccination program in the Irish health-care setting from the health-care payers' perspective. Methods: A model was constructed in MS Excel to follow a cohort of vaccinated and unvaccinated individuals from birth over a 5-year period. The reduction in events that would be associated with PCV7 vaccination and the mortality and cost resulting from these events were analyzed. In a separate submodel, the effect of herd immunity was investigated. Results: Implementing a PCV7 vaccine program in Ireland in a birth cohort of 61,000 infants would be expected to prevent 7703 cases of pneumococcal-related infections over 5 years, resulting in costs avoided of €2.05 million increasing to €4.6 million if the effect of herd immunity was included. The baseline incremental cost-effectiveness ratio was €249,591/life years gained (LYG), which reduced to €5997/LYG when the effect of herd immunity was included. Conclusions: A universal infant pneumococcal conjugate vaccination could be considered highly cost-effective in the Irish health-care setting from a health-care payers' perspective, if viewed in terms of the herd immunity effect. The results of this study have positive ramifications for countries in the early stages of health technology assessment. © 2008, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).