Estimating the cost-effectiveness of pneumococcal conjugate vaccination in Brazil. 2009

Glaucia Vespa, and Dagna O Constenla, and Camila Pepe, and Marco Aurélio Safadi, and Eitan Berezin, and José Cássio de Moraes, and Carlos Alberto Herrerias de Campos, and Denizar Vianna Araujo, and Ana Lucia S S de Andrade
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

OBJECTIVE To compare the costs and benefits of pneumococcal conjugate vaccination compared with no vaccination from the perspectives of the health care system and society. METHODS Using data from established sources, we estimated the incidence and mortality due to invasive pneumococcal disease, pneumonia, and acute otitis media (AOM) for a hypothetical birth cohort of children from birth to 5 years. RESULTS A universal pneumococcal conjugate vaccination program was estimated capable of annually avoiding 1 047 cases of invasive disease, 58 226 cases of pneumonia, and 209 862 cases of AOM. When herd immunity effects were considered, the program prevented 1.3 million cases of pneumococcal disease and over 7 000 pneumococcal deaths. At a vaccination cost of R$ 51.12 (US$ 26.35) per dose, vaccination would cost annually R$ 4 289 (US$ 2,211) per disability-adjusted life years averted. This does not take into account herd immunity effects. CONCLUSIONS At the current vaccine price, conjugate vaccination could be a cost-effective investment compared to other options to control childhood diseases. Further analysis is required to determine whether vaccination at the current price is affordable to Brazil.

UI MeSH Term Description Entries
D011008 Pneumococcal Infections Infections with bacteria of the species STREPTOCOCCUS PNEUMONIAE. Streptococcus pneumoniae Infections,Infections, Pneumococcal,Infections, Streptococcus pneumoniae,Pneumococcal Diseases,Disease, Pneumococcal,Diseases, Pneumococcal,Infection, Pneumococcal,Infection, Streptococcus pneumoniae,Pneumococcal Disease,Pneumococcal Infection,Streptococcus pneumoniae Infection
D001938 Brazil A country located on the eastern coast of South America, located between Colombia and Peru, that borders the Atlantic Ocean. It is bordered on the north by Venezuela, Guyana, Suriname, and French Guiana, on the south by Uruguay, and on the west by Argentina. The capital is Brasilia.
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013179 Spouse Abuse Deliberate severe and repeated injury to one domestic partner by the other. Partner Abuse,Wife Abuse,Spousal Abuse,Abuse, Partner,Abuse, Spousal,Abuse, Spouse,Abuse, Wife
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D018074 Vaccines, Conjugate Semisynthetic vaccines consisting of polysaccharide antigens from microorganisms attached to protein carrier molecules. The carrier protein is recognized by macrophages and T-cells thus enhancing immunity. Conjugate vaccines induce antibody formation in people not responsive to polysaccharide alone, induce higher levels of antibody, and show a booster response on repeated injection. Conjugate Vaccine,Conjugate Vaccines,Vaccine, Conjugate
D022242 Pneumococcal Vaccines Vaccines or candidate vaccines used to prevent infections with STREPTOCOCCUS PNEUMONIAE. Pneumococcal Polysaccharide Vaccine,Pneumococcal Vaccine,Pneumovax,Pnu-Imune Vaccine,Pnu Imune Vaccine,PnuImune Vaccine,Polysaccharide Vaccine, Pneumococcal,Vaccine, Pneumococcal,Vaccine, Pneumococcal Polysaccharide,Vaccines, Pneumococcal

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