Cost-Effectiveness of the 13-Valent (PCV13) Versus 10-Valent (PCV10) Pneumococcal Conjugate Vaccines as Part of Routine Infant Pneumococcal Vaccination in Mexico

Abstract

Background. Vaccination is an effective intervention to prevent the significant morbidity and mortality associated with pneumococcal disease. The objective of this study is to expand on a previously published cost-effectiveness analysis of immunization strategies based on PCVs in Mexico, by directly comparing the cost-effectiveness of PCV13 versus PCV10 and including the impact of indirect effects, local Mexican epidemiologic inputs and more recent cost data. Methods. A 1-year steady state decision analytic model was used to estimate lifetime costs and outcomes of vaccinating 85% of an annual birth cohort of 2.2 million Mexican infants in a number of scenarios from the institutional public payer perspective. Both vaccines were compared to no-vaccination and to one another in preventing cases and associated costs of invasive pneumococcal disease (IPD), community acquired pneumonia (CAP), and acute otitis media (AOM). Epidemiologic and economic inputs were derived from local Mexican surveillance data and the published literature. Costs and outcomes were discounted at a rate of 5%. Results. In the base case analysis PCV13 vaccination is projected to prevent more episodes and deaths, and is cost-saving compared to PCV10 (table). Furthermore, PCV13 consistently provides the greatest public health impact and remains cost-saving versus PCV10 across multiple scenarios including PCV10's potential herd effect against IPD. Conclusion. A National Immunization Program (NIP) with PCVs would continue to have a remarkable public health impact in Mexico. Use of PCV13 would maximize reductions in cases, death, and be cost-saving compared with PCV10. Sustained funding for NIP may be warranted. (Table Presented) .