Impact of routine PCV7 (Prevenar) vaccination of infants on the clinical and economic burden of pneumococcal disease in Malaysia

BMC Infectious Diseases

Research Article

Adrian Goh¹  Zafar Ahmed²  Amrizal Muhd Nur²  Saperi Sulong²  Gulifeiya Abuduxike³  Syed Aljunid⁴ 

[1] Azmi Burhani Consulting, Kelana Jaya, Malaysia;International Case-Mix and Clinical Coding Centre, UKM Medical Centre, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia;United Nations University-International Institute For Global Health, Kuala Lumpur, Malaysia;United Nations University-International Institute For Global Health, Kuala Lumpur, Malaysia;International Case-Mix and Clinical Coding Centre, UKM Medical Centre, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia;

关键词: Otitis Medium;    Invasive Pneumococcal Disease;    Pneumococcal Disease;    Pneumococcal Meningitis;    Herd Effect;   

DOI  :  10.1186/1471-2334-11-248

 received in 2011-04-19, accepted in 2011-09-21,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundPneumococcal 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.MethodsA 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.ResultsAt 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.ConclusionsPCV7 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).

【 授权许可】

CC BY   
© Aljunid et al; licensee BioMed Central Ltd. 2011