PharmacoEconomics & Outcomes News 598 - 6 Mar 2010 Indirect effects greatly affect Prevnar costs Incorporating indirect effects into cost-effectiveness models of infant vaccination with Prevnar [pneumococcal 7-valent CRM197 vaccine conjugate] hugely affects the costs and outcomes associated with the vaccine, according to a Dutch study. Researchers modified a previously published static cohort model to calculate costs and outcomes for routine Prevnar vaccination in infants for the prevention of pneumococcal disease. A Dutch setting was assumed and the model was run both with and without the effects of herd immunity and serotype replacement. A time horizon of 5 years was used. Costs were calculated from a societal perspective and expressed in 2008 values. Without net-indirect effects, Prevnar vaccination was estimated to prevent 5778 cases of noninvasive disease and 128 cases of invasive disease, resulting in a total gain of 422 QALYs. By contrast, when indirect effects were taken into account, Prevnar vaccination was associated with an additional 1117 QALYs gained, and lower costs by €4.8 million. The resulting cost- effectiveness ratios of Prevnar vaccination were €72 360 (indirect effects ignored) and €16 750 (indirect effects included) per QALY gained, respectively. The researchers concluded that "the exact assumption applied to indirect effects hugely determine cost- effectiveness estimates for PCV-7 vaccination". Rozenbaum MH, et al. Huge impact of assumptions on indirect effects on the cost- effectiveness of routine infant vaccination with 7-valent conjugate vaccine (Prevnar). Vaccine : 16 Jan 2010. Available from: URL: http://dx.doi.org/10.1016/ j.vaccine.2010.01.005 803005713 1 PharmacoEconomics & Outcomes News 6 Mar 2010 No. 598 1173-5503/10/0598-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

Indirect effects greatly affect Prevnar costs

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PharmacoEconomics & Outcomes News 598 - 6 Mar 2010

Indirect effects greatly affectPrevnar costs

Incorporating indirect effects into cost-effectivenessmodels of infant vaccination with Prevnar[pneumococcal 7-valent CRM197 vaccine conjugate]hugely affects the costs and outcomes associated withthe vaccine, according to a Dutch study.

Researchers modified a previously published staticcohort model to calculate costs and outcomes forroutine Prevnar vaccination in infants for the preventionof pneumococcal disease. A Dutch setting was assumedand the model was run both with and without the effectsof herd immunity and serotype replacement. A timehorizon of 5 years was used. Costs were calculated froma societal perspective and expressed in 2008 values.

Without net-indirect effects, Prevnar vaccination wasestimated to prevent 5778 cases of noninvasive diseaseand 128 cases of invasive disease, resulting in a totalgain of 422 QALYs. By contrast, when indirect effectswere taken into account, Prevnar vaccination wasassociated with an additional 1117 QALYs gained, andlower costs by €4.8 million. The resulting cost-effectiveness ratios of Prevnar vaccination were€72 360 (indirect effects ignored) and €16 750 (indirecteffects included) per QALY gained, respectively. Theresearchers concluded that "the exact assumptionapplied to indirect effects hugely determine cost-effectiveness estimates for PCV-7 vaccination".Rozenbaum MH, et al. Huge impact of assumptions on indirect effects on the cost-effectiveness of routine infant vaccination with 7-valent conjugate vaccine(Prevnar). Vaccine : 16 Jan 2010. Available from: URL: http://dx.doi.org/10.1016/j.vaccine.2010.01.005 803005713