Cost-effectiveness analysis of pneumococcal vaccination for infants in China.
Although China has a high burden of pneumococcal disease among young children, the government does not administer publicly-funded pneumococcal conjugate vaccines (PCV) through its Expanded Program on Immunization (EPI). We evaluated the cost-effectiveness of publicly-funded PCV-7, PCV-10, and PCV-13 vaccination programs for infants in China.



Using a Markov model, we simulated a cohort of 16 million Chinese infants to estimate the impact of PCV-7, PCV-10, and PCV-13 vaccination programs from a societal perspective. We extrapolated health states to estimate the effects of the programs over the course of a lifetime of 75years. Parameters in the model were derived from a review of the literature.



We found that PCV-7, PCV-10, and PCV-13 vaccination programs would be cost-effective compared to no vaccination. However, PCV-13 had the lowest incremental cost-effectiveness ratio ($11,464/QALY vs $16,664/QALY for PCV-10 and $18,224/QALY for PCV-7) due to a reduction in overall costs. Our sensitivity analysis revealed that the incremental cost-effectiveness ratios were most sensitive to the utility of acute otitis media, the cost of PCV-13, and the incidence of pneumonia and acute otitis media.



The Chinese government should take steps to reduce the burden of pneumococcal diseases among young children through the inclusion of a pneumococcal conjugate vaccine in its EPI. Although all vaccinations would be cost-effective, PCV-13 would save more costs to the healthcare system and would be the preferred strategy.
Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: maurerka@umich.edu.
Kristin A
KA
Maurer
Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: hfenchen@umich.edu.
Huey-Fen
HF
Chen
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: awag@umich.edu.
Abram L
AL
Wagner
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: hegdes@umich.edu.
Sonia T
ST
Hegde
Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: tejasi@umich.edu.
Tejasi
T
Patel
Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States; Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States. Electronic address: mboulton@umich.edu.
Matthew L
ML
Boulton
Department of Health Management and Policy, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: dwhutton@umich.edu.
David W
DW
Hutton
D002681:China / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage / Q000191:economics*; D006801:Humans; D007223:Infant; D011008:Pneumococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000191:economics*; D014611:Vaccination / Q000191:economics*
C586648:10-valent pneumococcal conjugate vaccine; C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines
13-valent pneumococcal vaccine; China; Cost-effectiveness analysis; Meningitis; Otitis media; Pneumonia