The cost-burden of paediatric pneumococcal disease in Sweden and the potential cost-effectiveness of prevention using 7-valent pneumococcal vaccine.
OBJECTIVE
A cost-effectiveness model was used to estimate the change in disease burden that might be expected if PCV7 was included as part of the routine 3-dose vaccination schedule in Sweden.


METHODS
An economic model was populated with data from the main clinical PCV7 efficacy trials, demographic data from government sources, surveillance and epidemiologic data from the US and Nordic region, and average treatment costs, considering the impact of disease on the whole national population.


RESULTS
The model estimated that PCV7 would prevent 18,856 cases of AOM, 684 of pneumonia, 86 of pneumococcal bacteraemia and 21 cases of pneumococcal meningitis in children <10 years, further 221 cases of IPD would be avoided in older children and adults and 397 cases of pneumonia in adults aged 18-39 years. Annually, 4 childhood (<10 years) deaths and 39 deaths in older children and adults would be prevented, resulting in an annual saving of 632 life years. The reduction of cost for the society was estimated to 27.9 (-205, +160) million SEK. The sensitivity analysis showed that it was most sensitive to the efficacy of the vaccine against AOM, the cost of managing infections and the incidence of all disease.


CONCLUSIONS
This model demonstrates that implementing a universal vaccine programme in Sweden with PCV7 would be cost-effective with an estimated net reduction of costs for the society.
Silfverdal
Sven Arne
SA
Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden. sven.arne.silfverdal@pediatria.umu.se
Berg
Stefan
S
Hemlin
Claes
C
Jokinen
Iiro
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D032521:Immunity, Herd; D007223:Infant; D007231:Infant, Newborn; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D008875:Middle Aged; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics; D010033:Otitis Media / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000494:pharmacology*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines