title: Economic evaluation of vaccination programme of 13-valent pneumococcal conjugate vaccine to the birth cohort in Japan.
abstract: Japan is now preparing to incorporate PCV-7 into the national childhood immunisation programme. Our recently published economic evaluation of using PCV-7 to the birth cohort suggests that the cost to gain one QALY is lower than the WHO's cost-effectiveness criterion for intervention. However, many countries have started to introduce PCV-13 into their national immunisation schedule replacing PCV-7 for preventing pneumococcal diseases among young children. These raise the need to appraise the 'value for money' of replacing PCV-7 with PCV-13 vaccination programme in Japan. We conducted a cost-effectiveness analysis with Markov model and calculated incremental cost effectiveness ratios (ICERs). Our base-case analyses, which assumed both PCVs have no net indirect effect and set the cost of PCV-7/PCV-13 per shot at ¥10,000 (US$125)/¥13,000 (US$163). The results show that in Base-case A (assumed PCV-13 has no additional protection against AOM compared to PCV-7), replacing PCV-7 with PCV-13 will cost ¥37,722,901 (US$471,536) or ¥35,584,455 (US$444,850) per QALY when the caregiver's productivity loss is not included or is included, respectively. While in Base-case B (assumed PCV-13 has additional protection against AOM compared to PCV-7), ¥343,830 (US$4298) per QALY or more QALY is gained by saving money without or with caregiver's productivity loss, respectively. We also find that, in Base-case B if cost per PCV-13 shot is equal to or less than that ¥17,000, then a PCV-13 vaccination programme offered to the birth cohort in Japan is likely to be a socially acceptable option compared to the current PCV-7 vaccination programme. Furthermore, if cost per PCV-13 shot is equal to or less than ¥12,000, replacing PCV-7 with PCV-13 will save money and gain more QALYs. While in Base-case A, the replacement can only be socially acceptable if cost per PCV-13 shot is equal to or less than ¥11,000.
authors.affiliation: Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577, Japan. hoshi@hcs.tsukuba.ac.jp
authors.forename: Shu-ling
authors.initials: SL
authors.lastname: Hoshi
authors.forename: Masahide
authors.initials: M
authors.lastname: Kondo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Okubo
mesh_terms: D002648:Child; D003362:Cost-Benefit Analysis; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007564:Japan; D008390:Markov Chains; D011008:Pneumococcal Infections / Q000191:economics / Q000276:immunology / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000276:immunology; D019057:Quality-Adjusted Life Years; D013296:Streptococcus pneumoniae / Q000276:immunology; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000191:economics / Q000276:immunology
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate