title: Comparing health outcomes and costs of general vaccination with pneumococcal conjugate vaccines in Sweden: a Markov model.
abstract: BACKGROUND
  Two new pneumococcal conjugate vaccines were licensed to immunize infants and young children against pneumococcal disease.
  
  
  OBJECTIVE
  The objective of this study was to estimate the expected health benefits, costs, and incremental cost-effectiveness of routine vaccination with the 10-valent pneumococcal nontypeable hemophilus influenza protein-D conjugate vaccine (PHiD-CV) compared with the 13-valent pneumococcal conjugate vaccine (PCV13) in Sweden.
  
  
  METHODS
  A Markov cohort model was used to estimate the effect of vaccination at vaccine steady state, taking a societal perspective and using a 2+1 vaccination schedule. Price parity was assumed between the vaccines. Outcomes were measured by reduction in disease burden, costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio.
  
  
  RESULTS
  The results predicted that PCV13 would prevent 3 additional cases of invasive pneumococcal disease and 34 additional cases of pneumonia, whereas PHiD-CV would avoid 3 additional cases of mastoiditis, 1010 tube insertions, and 10,420 cases of ambulatory acute otitis media compared with PCV13. By combining morbidity and mortality benefits of all clinical outcomes, PHiD-CV would generate 45.3 additional QALYs compared with PCV13 and generate savings of an estimated 62 million Swedish kronors.
  
  
  CONCLUSIONS
  The present study predicted lower costs and better health outcome (QALYs) gained by introducing PHiD-CV compared with PCV13 in routine vaccination. Our results indicated that PHiD-CV is cost-effective compared with PCV13 in Sweden.
authors.affiliation: GlaxoSmithKline AB, Solna, Sweden.
authors.forename: Asa
authors.initials: A
authors.lastname: By
authors.forename: Patrik
authors.initials: P
authors.lastname: Sobocki
authors.forename: Arne
authors.initials: A
authors.lastname: Forsgren
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Silfverdal
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008390:Markov Chains; D018803:Models, Economic; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D011008:Pneumococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D019057:Quality-Adjusted Life Years; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: C538862:13-valent pneumococcal vaccine; C547294:PHiD-CV vaccine; D022242:Pneumococcal Vaccines