title: Convincing or confusing? Economic evaluations of childhood pneumococcal conjugate vaccination--a review (2002-2006).
abstract: We review 15 economic analyses of pneumococcal conjugate vaccines, published between 2002 and 2006, in terms of methodology, assumptions, results and conclusions. We found a great diversity in assumptions (eg, vaccine efficacy parameters, incidence rates for both invasive and non-invasive disease) mainly due to local variation in data and opinions. Accordingly, the results varied greatly, from total net savings to over euro 100,000 per discounted QALY gained. The cost of the vaccination program (determined by price per dose and schedule (4 or 3 doses, or fewer)), and likely herd immunity impacts are highly influential though rarely explored in these published studies. If the net long-term impact (determined by a mixture of effects related to herd immunity, serotype replacement, antibiotic resistance and cross reactivity) remains beneficial and if a 3-dose schedule confers near-equivalent protection to a 4-dose schedule, the cost-effectiveness of PCV7 vaccination programs can be viewed as attractive in developed countries.
authors.affiliation: Centre for the Evaluation of Vaccination, Epidemiology and Social Medicine, University of Antwerp (Campus Drie Eiken), Universiteitsplein 1, 2610 Antwerp, Belgium. philippe.beutels@ua.ac.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
authors.forename: Nancy
authors.initials: N
authors.lastname: Thiry
authors.forename: Pierre
authors.initials: P
authors.lastname: Van Damme
mesh_terms: D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011008:Pneumococcal Infections / Q000191:economics / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000191:economics*; D013296:Streptococcus pneumoniae / Q000276:immunology*; D014611:Vaccination / Q000191:economics*; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000191:economics
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate