Cost-effectiveness of the 13-valent pneumococcal conjugate vaccine compared to the 10-valent vaccine in children: predictive analysis in the Ecuadorian context

摘要

Objective To evaluate the cost-effectiveness and economic impact of changing childhood vaccination from the 10-valent pneumococcal conjugate vaccine (PCV10) to the 13-valent pneumococcal conjugate vaccine (PCV13) in the context of the Ecuadorian health system. Methods A Markov model was developed based on a hypothetical cohort of children 65 years). So, PCV13 reduces incident cases of IPD in this adult population by 27.8 compared to PCV10. Simulation of the model in a cohort of 100 000 children <1 year old showed an incidence of 25 cases of IPD with PCV13 versus 40 cases with PCV10, that is, a reduction of 37.5. A reduction compared to PCV10 in the incidence of pneumonia and meningitis of 30.2 and 57.1, respectively, was demonstrated. PCV13 decreased mortality by 32 compared to PCV10. Conclusions Vaccination with PCV13 is cost-saving in the Ecuadorian health context and significantly reduces morbidity and mortality in children 65 years due to the herd effect. The probabilistic analysis showed consistency in the results.