Economic evaluation of a universal childhood pneumococcal conjugate vaccination strategy in Ireland.
OBJECTIVE
To evaluate the cost-effectiveness of implementing a universal infant 7-valent pneumococcal conjugate vaccine (PCV7) vaccination program in the Irish health-care setting from the health-care payers' perspective.


METHODS
A model was constructed in MS Excel to follow a cohort of vaccinated and unvaccinated individuals from birth over a 5-year period. The reduction in events that would be associated with PCV7 vaccination and the mortality and cost resulting from these events were analyzed. In a separate submodel, the effect of herd immunity was investigated.


RESULTS
Implementing a PCV7 vaccine program in Ireland in a birth cohort of 61,000 infants would be expected to prevent 7703 cases of pneumococcal-related infections over 5 years, resulting in costs avoided of 2.05 million euros increasing to 4.6 million euros if the effect of herd immunity was included. The baseline incremental cost-effectiveness ratio was 249,591 euros/life years gained (LYG), which reduced to 5997 euros/LYG when the effect of herd immunity was included.


CONCLUSIONS
A universal infant pneumococcal conjugate vaccination could be considered highly cost-effective in the Irish health-care setting from a health-care payers' perspective, if viewed in terms of the herd immunity effect. The results of this study have positive ramifications for countries in the early stages of health technology assessment.
Tilson
Lesley
L
National Centre for Pharmacoeconomics, St. James's Hospital, Dublin, Ireland.
Usher
Cara
C
Butler
Karina
K
Fitzsimons
John
J
O'Hare
Fiona
F
Cotter
Suzanne
S
O'Flanagan
Darina
D
Johnson
Howard
H
Barry
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D032521:Immunity, Herd; D007115:Immunization Schedule; D007223:Infant; D007494:Ireland; D008297:Male; D008586:Meningitis, Pneumococcal / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D008875:Middle Aged; D018803:Models, Economic; D015233:Models, Statistical; D011008:Pneumococcal Infections / Q000191:economics* / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics*; D011014:Pneumonia / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D015397:Program Evaluation / Q000191:economics; D019057:Quality-Adjusted Life Years; D018805:Sepsis / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D014611:Vaccination / Q000191:economics*; D018074:Vaccines, Conjugate / Q000191:economics
D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate