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The impact and cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the paediatric immunisation programme in Iceland—A population-based time series analysis

Author

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  • Elias Eythorsson
  • Tinna L Ásgeirsdóttir
  • Helga Erlendsdóttir
  • Birgir Hrafnkelsson
  • Karl G Kristinsson
  • Ásgeir Haraldsson

Abstract

Introduction: Streptococcus pneumoniae is a cause of infections that range in severity from acute otitis media (AOM) to pneumonia and invasive pneumococcal disease (IPD). The 10-valent pneumococcal conjugate vaccine (PHiD-CV10) was introduced into the Icelandic paediatric immunisation programme in 2011. The aim was to estimate the population impact and cost-effectiveness of PHiD-CV10 introduction. Methods: Data on primary care visits from 2005–2015 and hospitalisations from 2005–2017 were obtained from population-based registries. A Bayesian time series analysis with synthetic controls was employed to estimate the number of cases of AOM, pneumonia and IPD that would have occurred between 2013–2017, had PHiD-CV10 not been introduced. Prevented cases were calculated by subtracting the observed number of cases from this estimate. The cost of the programme was calculated accounting for cost-savings due to prevented cases. Results: The introduction of PHiD-CV10 prevented 13,767 (95% credible interval [CI] 2,511–29,410) visits for AOM from 2013–2015, and prevented 1,814 (95%CI -523-4,512) hospitalisations for pneumonia and 53 (95%CI -17-177) admissions for IPD from 2013–2017. Visits for AOM decreased both among young children and among children 4–19 years of age, with rate ratios between 0.72–0.89. Decreases were observed in both pneumonia hospitalisations (rate ratios between 0.67–0.92) and IPD (rate ratios between 0.27–0.94). The total cost of implementing PHiD-CV10 in Iceland was -7,463,176 United States Dollars (USD) (95%CI -16,159,551–582,135) with 2.1 USD (95%CI 0.2–4.7) saved for every 1 USD spent. Conclusions: The introduction of PHiD-CV10 was associated with large decreases in visits and hospitalisations for infections commonly caused by pneumococcus and was cost-saving during the first five years of the immunisation programme.

Suggested Citation

  • Elias Eythorsson & Tinna L Ásgeirsdóttir & Helga Erlendsdóttir & Birgir Hrafnkelsson & Karl G Kristinsson & Ásgeir Haraldsson, 2021. "The impact and cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the paediatric immunisation programme in Iceland—A population-based time series analysis," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-24, April.
    • Handle: RePEc:plo:pone00:0249497
    DOI: 10.1371/journal.pone.0249497
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    References listed on IDEAS

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    1. Katelijne Vooren & Silvy Duranti & Alessandro Curto & Livio Garattini, 2014. "Cost Effectiveness of the New Pneumococcal Vaccines: A Systematic Review of European Studies," PharmacoEconomics, Springer, vol. 32(1), pages 29-45, January.
    2. Ana Lucia Andrade & Eliane T Afonso & Ruth Minamisava & Ana Luiza Bierrenbach & Elier B Cristo & Otaliba L Morais-Neto & Gabriela M Policena & Carla M A S Domingues & Cristiana M Toscano, 2017. "Direct and indirect impact of 10-valent pneumococcal conjugate vaccine introduction on pneumonia hospitalizations and economic burden in all age-groups in Brazil: A time-series analysis," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-19, September.
    3. The Editor, 2018. "Introduction from the editor," Journal of Cyber Policy, Taylor & Francis Journals, vol. 3(1), pages 1-4, January.
    4. Marisa Holubar & Maria Christina Stavroulakis & Yvonne Maldonado & John P A Ioannidis & Despina Contopoulos-Ioannidis, 2017. "Impact of vaccine herd-protection effects in cost-effectiveness analyses of childhood vaccinations. A quantitative comparative analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-22, March.
    5. Surasak Saokaew & Ajaree Rayanakorn & David Bin-Chia Wu & Nathorn Chaiyakunapruk, 2016. "Cost Effectiveness of Pneumococcal Vaccination in Children in Low- and Middle-Income Countries: A Systematic Review," PharmacoEconomics, Springer, vol. 34(12), pages 1211-1225, December.
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