OBJECTIVES: To estimate the expected impact of the newly licensed 10-valent pneumococcal non-typeable Haemophilus influenzae protein-D conjugate vaccine (PHiDCV) on health care budgets in Canada.
METHODS: The budget impact analysis (BIA) uses the previously published PHiD-CV population model. The BIA compares a PCV- 7-primed condition at vaccine steady state with the introduction of PHiD-CV within the Canadian market assuming a gradual annual uptake of 20% over 5 years (2009– 2013). The market share assumptions are based on 100% vaccination coverage in a 4-dose (3 + 1) schedule. The population modeled is the entire population of Canada (33.0 million). The vaccinated cohort is 348,000. Analysis was performed from the Canadian health care system perspective assuming a price parity of $70 per dose. The model includes the direct medical costs related to the management of invasive pneumococcal diseases, community acquired pneumonia and acute otitis media (AOM) obtained from published Canadian studies. Various sensitivity analyses were performed to assess the robustness of the key model assumptions.
RESULTS: Assuming a 20% market share in Year 1 (2009), the introduction of PHiD-CV will result in a cost-savings of $4.7 million, compared with PCV-7 at price parity. In 2013 (Year 5), with PHiD-CV market share increasing to 100%, the expected annual direct cost savings is estimated to grow to $23.6 million, resulting in cumulative cost savings of $70.9 million over 5 years. Approximately 70% of the projected savings is due to the superior AOM protection offered by PHiD-CV vaccination. Sensitivity analyses show that change in vaccination price, dosing strategy, and vaccine coverage have the biggest impact on projected cost-savings.
CONCLUSIONS: The results suggest that the Canadian health care system can realize substantial cost savings by substituting PCV-7 with PHiD-CV in routine infant pneumococcal vaccination programs. With 100% substitution, annual direct cost savings is projected to be $67.9 per child vaccinated.
