title: Cost-effectiveness analysis of the 10- and 13-valent pneumococcal conjugate vaccines in Argentina.
abstract: OBJECTIVE
  Since the 10-valent pneumococcal conjugate vaccine (PCV-10) and 13-valent pneumococcal conjugate vaccine (PCV-13) were recently licensed for use in Argentina, both vaccines were evaluated to estimate the costs, health benefits and cost-effectiveness of adding a PCV to the routine child immunization schedule.
  
  
  METHODS
  The integrated TRIVAC vaccine cost-effectiveness model from Pan American Health Organization's ProVac Initiative (Version 1.0.65) was used to assess the health outcomes of 20 successive cohorts from birth to 5 years of age. PCV-10 and PCV-13 were each compared to a scenario assuming no PCV vaccination. A 3+1 (three doses+booster) schedule and a vaccination price of US$ 20.75 per dose was assumed in the base case for both vaccines.
  
  
  RESULTS
  Introduction of PCV-13 rather than PCV-10 would increase the number of life years gained (LYG) by at least 10%. The number of LYG (and LYG after adjustment for DALY morbidity weights) was 56,882 (64,252) for PCV-10 compared to 65,038 (71,628) for PCV-13. From the health system perspective, the cost per DALY averted was US$ 8973 and US$ 10,948 for PCV-10 and PCV-13 respectively, and US$ 8546 and US$ 10,510 respectively, after incorporating costs saved by households. When PCV13 was compared to PCV10 directly, the additional benefits of PCV-13 was conferred at a cost of US$ 28,147 per DALY averted. Cost-effectiveness was influenced mainly by vaccine price, serotype replacement, pneumonia mortality and discount rate.
  
  
  CONCLUSIONS
  Routine vaccination against S. pneumoniae in Argentina would be cost-effective with either PCV-10 or PCV-13. PCV-13, with higher coverage of local serotypes, would prevent more cases of pneumonia, invasive pneumococcal disease, sequelae and deaths with a higher number of LYG and DALYs averted, but PCV-10, due its higher impact in the prevention of AOM, would save more costs to the healthcare system.
authors.affiliation: Ministerio de Salud de la Nación, Argentina. anauru@yahoo.com
authors.forename: Analía
authors.initials: A
authors.lastname: Urueña
authors.forename: Tomás
authors.initials: T
authors.lastname: Pippo
authors.forename: María Sol
authors.initials: MS
authors.lastname: Betelu
authors.forename: Federico
authors.initials: F
authors.lastname: Virgilio
authors.forename: Norberto
authors.initials: N
authors.lastname: Giglio
authors.forename: Angela
authors.initials: A
authors.lastname: Gentile
authors.forename: Salvador García
authors.initials: SG
authors.lastname: Jimenez
authors.forename: Bárbara
authors.initials: B
authors.lastname: Jáuregui
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Clark
authors.forename: Máximo
authors.initials: M
authors.lastname: Diosque
authors.forename: Carla
authors.initials: C
authors.lastname: Vizzotti
mesh_terms: D001118:Argentina / Q000453:epidemiology; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015233:Models, Statistical; D011008:Pneumococcal Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000276:immunology*
chemical_list: C538863:10-valent pneumococcal vaccine; C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines