title: Huge impact of assumptions on indirect effects on the cost-effectiveness of routine infant vaccination with 7-valent conjugate vaccine (Prevnar).
abstract: Several recently published European cost-effectiveness studies on the 7-valent pneumococcal conjugate vaccine (PCV-7: Prevnar((R))) have included net-indirect vaccine benefits for non-vaccine protected groups into their studies, which might be too optimistic an approach given recent data. Net-indirect effects result from herd protection minus serotype replacement effects. In this study we analyze the impact of net-indirect effects in non-vaccine protected groups of 5 years of age and older with updated assumptions regarding epidemiologic data and health care unit costs. Without net-indirect benefits for non-vaccine protected groups included the cost-effectiveness ratio is estimated at euro72,360 per QALY. In order to obtain cost-effectiveness ratios below the threshold of euro50,000 per QALY - which is in the middle of the range that is often referred to in the Netherlands - the net-indirect protective effect should at least be 16% of which has been observed in the USA after the introduction of PCV-7.
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics (PE(2)), Department of Pharmacy, University of Groningen, Groningen, The Netherlands. m.h.rozenbaum@rug.nl <m.h.rozenbaum@rug.nl>
authors.forename: Mark H
authors.initials: MH
authors.lastname: Rozenbaum
authors.forename: Albert Jan van
authors.initials: AJ
authors.lastname: Hoek
authors.forename: Eelko
authors.initials: E
authors.lastname: Hak
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Postma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D032521:Immunity, Herd; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000276:immunology*; D014611:Vaccination / Q000191:economics*; D055815:Young Adult
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines