OBJECTIVES: Thirteen-valent pneumococcal conjugate vaccine (PCV13) and 10-valent pneumococcal conjugate vaccine (PCV10) are two approved vaccines for the active immunization against Streptococcus pneumoniae,causing invasive pneumococcal disease in infants and children. PCV13 offers broader protection against Streptococcus pneumoniae; however, PCV10 offers potential additional protection against non-typeable Haemophilus influenzae. We examined public health and economic impacts of a PCV10 and PCV13 pediatric national immunization programs (NIPs) in Canada.
METHODS: A decision-analytic model was developed to examine the costs and outcomes associated with a 2+1 dosing of PCV10 and 2+1 dosing of PCV13 pediatric NIP. The model followed patients over the remainder of their lifetime. Recent disease incidence, serotype coverage, population data, percent vaccinated, costs, and utilities were obtained from the published literature. Direct and indirect effects were derived from 7-valent pneumococcal vaccine. Additional direct effect of 4% was attributed to PCV10 for moderate to severe AOM to account for potential non-typeable Haemophilus influenzae benefit. Annual number of disease cases and costs (2010 CAN$) were presented.
RESULTS: In Canada, PCV13 prevented more cases of disease (7,465 when considering direct effects only and 49,340 when considering both direct and indirect effects) than PCV10. This translated to population gains of 80,565 to 94,134 more quality-adjusted life years when vaccinating with PCV13 versus PCV10. Use of PCV13 in children also reduced annual direct medical costs (including the cost of vaccination) by $5.8 to $132.8 million. Thus, PCV13 was found to dominate PCV10. One-way sensitivity analyses showed PCV13 to always be dominant or cost-effective versus PCV10.
CONCLUSIONS: Considering the epidemiology of pneumococcal disease in Canada, 2+1 dosing of PCV13 is shown to be a cost saving immunization program as it provides substantial public health and economic benefits relative to 2+1 dosing of PCV10.
