Cost-effectiveness analysis of 7-valent pneumococcal conjugate vaccine in prevention of pneumococcal disease within the SUS scenario

Abstract

OBJECTIVE: To perform a cost-effectiveness analysis comparing the incorporation of pneumococcal 7-valent conjugate vaccine in the pediatric immunization routine to non prophylaxis in prevention of invasive pneumococcal disease (IPD), acute otitis media (AOM) and pneumonia, from the Brazilian Public Healthcare System viewpoint. METHODS: A decision tree model was developed. The clinical outcomes were mortality and incidence rates. The target population was a hypothetic alive birth cohort in Brazil followed until 5 years of age. The vaccination coverage rate was 90% considering a four-dose schedule(3+1). Review and critical analysis of literature, public database information (DATASUS) and a clinical expert panel populated the model. The model includes only direct costs obtained from the Ambulatory and Hospital Information System and the Price Database of the Brazilian Ministry of Health. RESULTS: Without vaccination, 6,745,838 cases of IPD, pneumonia and AOM occur. The vaccine prevent 443,273 cases of pneumococcal disease and 9,053 deaths; avert BRL 1.1 millions (USD 796 millions) in pneumococcal disease treatment and result in BRL 462 millions (USD 330 millions) of economy in 5 years. (ICP, 2005) (Purchasing power parity index 1 USD = 1.4 BRL). CONCLUSIONS: This study suggests that investments in the pneumococcal vaccine result in reduction on mortality and in economy to the country.