Cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban national immunization programme

Abstract

Objectives: To evaluate the cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban National Immunization Program (NIP). Methods: 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. Results: 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. Conclusions: 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.

Keywords

• Pneumococcal conjugate vaccine
• Cost effectiveness
• Cuba