Finlay Vaccine Institute, Havana, Cuba.
Finlay Vaccine Institute, Havana, Cuba.
Int J Infect Dis. 2020 Aug;97:182-189. doi: 10.1016/j.ijid.2020.05.078. Epub 2020 May 29.
To evaluate the cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban National Immunization Program (NIP).
We compared PCV7-TT given at two, four and six months of age to a scenario without PCV7-TT, over a ten-year period (2020-2029). We calculated the cost (Cuban pesos - CUP) per Disability Adjusted Life Year (DALY) averted from a Government perspective. We compared results from a static cohort model and a parsimonious prediction model informed by the serotype distribution among pneumococcal carriers and cases. We ran probabilistic and deterministic uncertainty analyses.
PCV7-TT could prevent 6897 (95% uncertainty interval, 4344-8750) hospitalizations and 189 (115-253) deaths in children <5 years of age, over the period 2020-2029. This could cost around 25 million (20-31) discounted CUP but would be offset by treatment cost savings of around 23 million (14-31). A parsimonious model predicted less favourable impact and cost-effectiveness but the cost per DALY averted was still less than 0.4 times the current GDP per capita.
PCV7-TT is likely to be cost-effective in Cuba. The impact of the vaccine would need to be carefully monitored following its introduction into the NIP.
评估在古巴国家免疫规划（NIP）中引入国产肺炎球菌结合疫苗（PCV7-TT）的成本效益。
我们将在 2、4 和 6 个月龄时接种 PCV7-TT 的方案与不接种 PCV7-TT 的方案进行了比较，时间跨度为 10 年（2020-2029 年）。我们从政府角度计算了每避免一个残疾调整生命年（DALY）的成本（古巴比索-CUP）。我们比较了静态队列模型和由肺炎球菌携带者和病例的血清型分布提供信息的简约预测模型的结果。我们进行了概率和确定性不确定性分析。
在 2020-2029 年期间，PCV7-TT 可预防 6897 名（95%置信区间，4344-8750 名）5 岁以下儿童住院和 189 名（115-253 名）死亡。这可能需要花费约 2500 万（2000-3100 万）折扣 CUP，但可通过治疗成本节省约 2300 万（1400-3100 万）来抵消。一个简约模型预测了不太有利的影响和成本效益，但每 DALY 避免的成本仍然低于当前人均 GDP 的 0.4 倍。
PCV7-TT 在古巴可能具有成本效益。在将其纳入 NIP 后，需要仔细监测疫苗的效果。
