title: Cost-effectiveness of 13-valent pneumococcal conjugate vaccine: Germany, Greece, and The Netherlands.
abstract: BACKGROUND
  Seven-valent pneumococcal conjugate vaccine (PCV7) had profound public-health impacts and is considered cost-effective and potentially cost saving. Two new PCVs have been launched, a 10-valent vaccine (PCV10) and a 13-valent vaccine (PCV13). We examined public-health and economic impacts of PCV pediatric national immunization programs (NIPs) in Germany, Greece, and the Netherlands.
  
  
  METHODS
  A decision-analytic model was developed to estimate the impact of PCV13, PCV7, and 10-valent pneumococcal conjugate vaccine (PCV10) on invasive pneumococcal disease (IPD), pneumonia (PNE), and acute otitis media (AOM). Using epidemiological data, we calculated the cases of IPD, PNE, and AOM, using country-specific incidence, serotype coverage, disease sequelae, mortality, vaccine effectiveness, indirect effects, costs, and utilities. Direct effects for PCV13- and PCV10-covered serotypes were assumed similar to PCV7. PCV13 was assumed to confer an indirect effect, while PCV10 was not. Assumptions were tested in sensitivity analyses.
  
  
  RESULTS
  In a NIP, PCV13 was estimated to eliminate 31.7%, 46.4%, and 33.8% of IPD in Germany, Greece, and the Netherlands, respectively. Compared with PCV7 and PCV10, PCV13 was found to be cost-effective or cost saving in all cases when PCV13 indirect effects were included.
  
  
  CONCLUSIONS
  Pediatric NIPs with PCV13 in Europe are expected to have dramatic public-health impacts and be cost-effective or cost saving.
authors.affiliation: Pfizer Inc., Collegeville, PA 19426, USA. david.strutton@pfizer.com
authors.forename: David R
authors.initials: DR
authors.lastname: Strutton
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Farkouh
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Earnshaw
authors.forename: Sharon
authors.initials: S
authors.lastname: Hwang
authors.forename: Ulrike
authors.initials: U
authors.lastname: Theidel
authors.forename: Stathis
authors.initials: S
authors.lastname: Kontodimas
authors.forename: Rogier
authors.initials: R
authors.lastname: Klok
authors.forename: Sotiria
authors.initials: S
authors.lastname: Papanicolaou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands / Q000453:epidemiology; D011008:Pneumococcal Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000191:economics*; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines