OBJECTIVES: National 7-valent pneumococcal vaccination (PCV7) was introduced in Greece in 2006. In May 2009 a 10-valent (PCV10) vaccine became available. A 13-valent (PCV13) vaccine is expected in late 2009. This study aims to assess the clinical and economic benefits of national immunization with PCV13 compared to PCV7 and PCV10 from the national health system perspective.
METHODS: Using an EXCEL decision analytic model we considered disease incidence and sequelae, serotype coverage and health care utilization to compare costs and impact of PCV13 vs. PCV10, vs. PCV7 and vs. no vaccination on invasive pneumococcal disease (IPD), pneumonia, and otitis media, among vaccinated children (direct effects only) and the entire population while including indirect (herd) effects. Epidemiological data from Greek published studies and the National Statistical Service were supplemented by expert panel opinion and international literature. Published costs from the Athens University Paediatric Hospital and government price bulletins were employed, assuming price parity between PCV7 and PCV13. Only hospital treatment costs were considered and outcomes were discounted at 3%.
RESULTS: Immunization with PCV7, PCV10, and PCV13 would eliminate 74%, 82%, and 89% of IPD among vaccinated children, respectively. Assuming 84% vaccination rate with the recommended 3+1 dose schedule and adding indirect benefits, PCV13v vaccination would reduce IPD incidence by 63% in the total population versus no vaccination and would prevent an additional 6 and 4 deaths annually compared to PCV7/10 respectively. PCV13 vaccination would annually save EUR158K or EUR189K versus PCV7 and PCV10 respectively estimating only direct benefits, and EUR 803K or EUR 2324K respectively including indirect effects. Compared to no vaccination annual cost savings reached EUR 2403K (EUR 903K if considering only direct benefits).
CONCLUSIONS: Introducing PCV13 in the Greek National Immunization schedule would provide additional protection against pneumococcal disease and cost savings for the health care system vs. existing PCV vaccines.
