GSK Pte Ltd, 23 Rochester Park, Singapore, 139234, Singapore.
GSK, Auckland, New Zealand.
Appl Health Econ Health Policy. 2018 Jun;16(3):331-345. doi: 10.1007/s40258-018-0387-5.
Invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) still represent a significant medical burden in children < 5 years of age in New Zealand (NZ), with marked disparities across socio-economic and ethnic groups. This cost-effectiveness evaluation aims to compare the potential impact of two childhood universal immunisation strategies: vaccination with a 3 + 1 schedule of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix, GSK) and the 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13, Pfizer).
A static Markov-process cohort model was used to simulate the epidemiological and economic burden of pneumococcal diseases on a single-birth cohort over its lifetime. Costs and outcomes were discounted annually at 3.5%. Epidemiological and cost inputs were extracted from the most recently available NZ data, or derived from the most relevant reference countries' sources. The most updated evidence on the efficacies of the corresponding vaccines were used, particularly the significant effectiveness for PHiD-CV against IPD caused by serotype 19A.
The model estimated that both vaccines have a broadly comparable impact on IPD-related diseases and pneumonia. Due to the additional benefits possible through broader impact on AOM, PHiD-CV is estimated to potentially provide additional discounted cost offsets of approximately NZD 0.8 million over the lifetime of the birth cohort.
To ensure health equity in children, given the substantial burden of pneumonia and AOM, decision-makers should also take into account the impact of PCVs on these diseases for decisions relating to routine infant immunization.
HO-15-16775.
在新西兰（NZ），<5 岁儿童的侵袭性肺炎球菌病（IPD）、肺炎和急性中耳炎（AOM）仍然是一个重大的医疗负担，在社会经济和种族群体之间存在显著差异。本项成本效益评估旨在比较两种儿童普遍免疫策略的潜在影响：采用 10 价肺炎球菌无型流感嗜血杆菌蛋白 D 结合疫苗（PHiD-CV，Synflorix，GSK）和 13 价肺炎球菌结合疫苗（PCV13，Prevenar 13，辉瑞）的 3+1 计划进行免疫接种。
采用静态马尔可夫过程队列模型，模拟单胎队列一生中肺炎球菌疾病的流行病学和经济负担。成本和结果按 3.5%的年贴现率贴现。流行病学和成本投入从新西兰最近可用的数据中提取，或从最相关的参考国家的来源中推导得出。使用了相应疫苗最新的有效性证据，特别是 PHiD-CV 对 19A 血清型引起的 IPD 的显著有效性。
该模型估计两种疫苗对 IPD 相关疾病和肺炎都有大致相当的影响。由于对 AOM 的更广泛影响可能带来额外的益处，因此 PHiD-CV 估计在出生队列的一生中可能会带来约 80 万新西兰元的额外折扣成本节省。
鉴于肺炎和 AOM 的负担很重，为确保儿童健康公平，决策者在决策常规婴儿免疫接种时，还应考虑 PCV 对这些疾病的影响。
GSK 研究标识符：HO-15-16775。
