TY - JOUR
T1 - Impact of routine PCV7 (Prevenar) vaccination of infants on the clinical and economic burden of pneumococcal disease in Malaysia
AU - Aljunid, Syed
AU - Abuduxike, Gulifeiya
AU - Ahmed, Zafar
AU - Sulong, Saperi
AU - Nur, Amrizal M.
AU - Goh, Adrian
N1 - Funding Information:
We wish to thank the Director General of Health, Malaysia for permission to publish this paper. We would like to thank Drs Hasniah Abdul Latiff and Fauzi Mohd. Anshar of UKM Medical Centre, Drs Mohd Suhaimi Ab. Wahab and Shaharuddin Abdullah of Hospital Universiti Sains Malaysia, Dr. Chin Choy Nyok and Dato’ Dr. Haji Sapari Satwi of Hospital Tengku Ampuan Afzan, Dato’ Dr. Teh Keng Hwang and Dr. Mustafa Kamal Razak of Hospital Sultanah Bahiyah, Alor Setar, Drs Tan Kah Kee and Vijiya Mala of Hospital Tuanku Ja’afar, Seremban, and Drs Chan Lee Gaik and Kalwinder Singh Khaira of Sarawak General Hospital for their assistance during primary data collection. The preparation and publication of this manuscript was funded by a grant from Pfizer (M) Sdn Bhd.
PY - 2011/9/21
Y1 - 2011/9/21
N2 - Background: Pneumococcal disease is the leading cause of vaccine-preventable death in children younger than 5 years of age worldwide. The World Health Organization recommends pneumococcal conjugate vaccine as a priority for inclusion into national childhood immunization programmes. Pneumococcal vaccine has yet to be included as part of the national vaccination programme in Malaysia although it has been available in the country since 2005. This study sought to estimate the disease burden of pneumococcal disease in Malaysia and to assess the cost effectiveness of routine infant vaccination with PCV7.Methods: A decision model was adapted taking into consideration prevalence, disease burden, treatment costs and outcomes for pneumococcal disease severe enough to result in a hospital admission. Disease burden were estimated from the medical records of 6 hospitals. Where local data was unavailable, model inputs were obtained from international and regional studies and from focus group discussions. The model incorporated the effects of herd protection on the unvaccinated adult population.Results: At current vaccine prices, PCV7 vaccination of 90% of a hypothetical 550,000 birth cohort would incur costs of RM 439.6 million (US$128 million). Over a 10 year time horizon, vaccination would reduce episodes of pneumococcal hospitalisation by 9,585 cases to 73,845 hospitalisations with cost savings of RM 37.5 million (US$10.9 million) to the health system with 11,422.5 life years saved at a cost effectiveness ratio of RM 35,196 (US$10,261) per life year gained.Conclusions: PCV7 vaccination of infants is expected to be cost-effective for Malaysia with an incremental cost per life year gained of RM 35,196 (US$10,261). This is well below the WHO's threshold for cost effectiveness of public health interventions in Malaysia of RM 71,761 (US$20,922).
AB - Background: Pneumococcal disease is the leading cause of vaccine-preventable death in children younger than 5 years of age worldwide. The World Health Organization recommends pneumococcal conjugate vaccine as a priority for inclusion into national childhood immunization programmes. Pneumococcal vaccine has yet to be included as part of the national vaccination programme in Malaysia although it has been available in the country since 2005. This study sought to estimate the disease burden of pneumococcal disease in Malaysia and to assess the cost effectiveness of routine infant vaccination with PCV7.Methods: A decision model was adapted taking into consideration prevalence, disease burden, treatment costs and outcomes for pneumococcal disease severe enough to result in a hospital admission. Disease burden were estimated from the medical records of 6 hospitals. Where local data was unavailable, model inputs were obtained from international and regional studies and from focus group discussions. The model incorporated the effects of herd protection on the unvaccinated adult population.Results: At current vaccine prices, PCV7 vaccination of 90% of a hypothetical 550,000 birth cohort would incur costs of RM 439.6 million (US$128 million). Over a 10 year time horizon, vaccination would reduce episodes of pneumococcal hospitalisation by 9,585 cases to 73,845 hospitalisations with cost savings of RM 37.5 million (US$10.9 million) to the health system with 11,422.5 life years saved at a cost effectiveness ratio of RM 35,196 (US$10,261) per life year gained.Conclusions: PCV7 vaccination of infants is expected to be cost-effective for Malaysia with an incremental cost per life year gained of RM 35,196 (US$10,261). This is well below the WHO's threshold for cost effectiveness of public health interventions in Malaysia of RM 71,761 (US$20,922).
KW - Otitis Medium
KW - Invasive Pneumococcal Disease
KW - Pneumococcal Disease
KW - Pneumococcal Meningitis
KW - Herd Effect
UR - http://www.scopus.com/inward/record.url?scp=80053172303&partnerID=8YFLogxK
U2 - 10.1186/1471-2334-11-248
DO - 10.1186/1471-2334-11-248
M3 - Article
C2 - 21936928
AN - SCOPUS:80053172303
SN - 1471-2334
VL - 11
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 248
ER -