Estimating the Cost-Effectiveness of the 7-Valent Pneumococcal Conjugate Vaccine in Shanghai, China

AbstractObjectiveThe goal of this study was to analyze the economic benefits of introducing the 7-valent pneumococcal conjugate vaccine (PCV7) into the City Immunity Program in Shanghai.MethodsA decision-analytic model designed for pneumococcal disease and outcomes of pneumococcal infection was populated with local, age-specific incidence and cost data to estimate the expected economic benefits from vaccinating a birth cohort of 172,183 infants in Shanghai over a 1-year period using a cross-sectional approach. The analysis was assumed to occur in a year at which time the direct and indirect effects of vaccination have reached a steady state. Costs were calculated from a payer perspective and included vaccination program costs and direct medical expenditures from pneumococcal-related disease.ResultsThe model predicts that 112,629 cases of pneumococcal-related disease could be prevented during a given year following the introduction of the PCV7 vaccine into the City Immunity Program in Shanghai, leading to a reduction of ¥187,923,359 (US $29,067,790) in direct medical costs. Overall, the inclusion of the PCV7 vaccine is estimated to have a cost-per-life-year saved of ¥37,468 (US $5,796) and a cost-per-quality-adjusted-life-year gained of ¥41,603 (US $6,435) when both the direct and indirect effects of the vaccine resulting from herd protection are taken into account.ConclusionsResults suggest that including PCV7 into the City Immunity Program in Shanghai could be considered cost-effective under generally accepted willingness-to-pay thresholds when both the direct and indirect effects of the vaccine are considered in the analysis