title: [Cost-effectiveness analysis of pneumococcal vaccination in Spain].
abstract: OBJECTIVE
  To perform a cost-effectiveness analysis of pediatric pneumococcal vaccination in Spain.
  
  
  METHODS
  A deterministic population-based model in the form of a decision-tree with a 1-year time horizon was used to estimate the impact of vaccination with Synflorix® or Prevenar13® in children aged less than 2 years in Spain from the perspective of the National Health System. Epidemiological data were obtained from the hospital discharge minimum data set (MDS) and the literature. Data on costs were obtained from national health costs databases. The main outcomes measured were the number of cases avoided of invasive pneumococcal disease, acute otitis media (AOM) and myringotomies, and hospital admissions for pneumonia. All costs were expressed in 2010 euros. Effectiveness was measured as the number of quality-adjusted life years (QALYs) gained.
  
  
  RESULTS
  The efficacy of Synflorix® in preventing episodes of AOM caused by non-typeable Haemophilus influenzae could lead to additional prevention of 41,513 episodes of AOM, 36,324 antibiotic prescriptions and 382 myringotomy procedures and 143 QALYs gained compared with Prevenar13®. The total vaccination cost with Synflorix® would result in savings of 22 million euros.
  
  
  CONCLUSIONS
  Pneumococcal vaccination with Synflorix® in comparison with Prevenar13® in children aged less than 2 years old in Spain could achieve a higher number of QALYs and a substantial cost offset. Vaccination with Synflorix® would be a dominant strategy in terms of cost-effectiveness.
authors.affiliation: Departamento de Evaluación de Medicamentos, GlaxoSmithKline, Tres Cantos, Madrid, España. raul.l.morano-larragueta@gsk.com
authors.forename: Raúl
authors.initials: R
authors.lastname: Morano
authors.forename: Ferrán
authors.initials: F
authors.lastname: Pérez
authors.forename: Max
authors.initials: M
authors.lastname: Brosa
authors.forename: Isabel
authors.initials: I
authors.lastname: Pérez Escolano
mesh_terms: D016470:Bacteremia / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000191:economics; D008962:Models, Theoretical; D009313:National Health Programs / Q000191:economics; D010033:Otitis Media / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000191:economics / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics*; D019057:Quality-Adjusted Life Years; D013030:Spain / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*; D018074:Vaccines, Conjugate / Q000191:economics
chemical_list: C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; C547294:PHiD-CV vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate