Publication: Cost-utility analysis of 10- and 13-valent pneumococcal conjugate vaccines: protection at what price in the Thai context?
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Issued Date
2013-06
Resource Type
Language
eng
ISSN
1873-2518 (Electronic)
0264-410X (Linking)
0264-410X (Linking)
Rights
Mahidol university
Rights Holder(s)
ScienceDirect
Bibliographic Citation
Vaccine. Vol.31, No.26 (2013), 2839-2847
Suggested Citation
Wantanee Kulpenga, Pattara Leelahavarong, Waranya Rattanavipapong, Baggett, H. C, Vorasith Sornsrivichai, Aronrag Meeyai, Warunee Punpanich, อรุณรักษ์ มีใย Cost-utility analysis of 10- and 13-valent pneumococcal conjugate vaccines: protection at what price in the Thai context?. Vaccine. Vol.31, No.26 (2013), 2839-2847. doi:10.1016/j.vaccine.2013.03.047 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/2436
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Journal Issue
Thesis
Title
Cost-utility analysis of 10- and 13-valent pneumococcal conjugate vaccines: protection at what price in the Thai context?
Corresponding Author(s)
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Abstract
OBJECTIVE: This study aims to evaluate the costs and outcomes of offering the 10-valent pneumococcal conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13) in Thailand compared to the current situation of no PCV vaccination. METHODS: Two vaccination schedules were considered: two-dose primary series plus a booster dose (2+1) and three-dose primary series plus a booster dose (3+1). A cost-utility analysis was conducted using a societal perspective. A Markov simulation model was used to estimate the relevant costs and health outcomes for a lifetime horizon. Costs were collected and values were calculated for the year 2010. The results were reported as incremental cost-effectiveness ratios (ICERs) in Thai Baht (THB) per quality adjusted life year (QALY) gained, with future costs and outcomes being discounted at 3% per annum. One-way sensitivity analysis and probabilistic sensitivity analysis using a Monte Carlo simulation were performed to assess parameter uncertainty. RESULTS: Under the base case-scenario of 2+1 dose schedule and a five-year protection, without indirect vaccine effects, the ICER for PCV10 and PCV13 were THB 1,368,072 and THB 1,490,305 per QALY gained, respectively. With indirect vaccine effects, the ICER of PCV10 was THB 519,399, and for PCV13 was THB 527,378. The model was sensitive to discount rate, the change in duration of vaccine protection and the incidence of pneumonia for all age groups. CONCLUSIONS: At current prices, PCV10 and PCV13 are not cost-effective in Thailand. Inclusion of indirect vaccine effects substantially reduced the ICERs for both vaccines, but did not result in cost effectiveness.
Sponsorship
We would like to thank the Thai Health Promotion Foundation
and the Thailand Research Fund under the Senior Research
Scholar Program on the Development of Health Technology Assessment
Capacity in Thailand (RTA5580010) for funding support
through the Health Intervention and Technology Assessment Program
(HITAP). We are grateful for the support from Health Utilities
Inc. We wish to acknowledge the valuable information provided
by Pasakorn Akarasewi from the Bureau of Epidemiology,
Department of Disease Control, Julia Rhodes and Susan Maloney
from the International Emerging Infections Program (IEIP). Finally,
we would like to thank Virasakdi Chongsuvivatwong, Anchalee
Aramtiantamrong, Supalert Netsuwan, Manit Kongpan and Anek
Mungaomklang, for helpful comments.
Appendix A.