Pharmacoeconomics & Outcomes News
January 8, 2011 – Volume – Issue 619 pp: 1-11
http://adisonline.com/pecnews/pages/currenttoc.aspx

Vaccine studies show advances in health economic research
PharmacoEconomics & Outcomes News. (619):5, January 8, 2011.

Abstract
Using steady-state population-based analyses has the “advantage of helping policy makers understand the impact of their policy decisions on a population level in the year that the decision has reached its full effect” says Dr Lieven Annemans, of the medical faculties at Ghent and Brussels Universities. Dr Annemans was commenting on two vaccine studies that used steady-state population model included in a supplement entitled “Progress in vaccines, progress in health economics” published in Vaccine. The supplement, sponsored by GlaxoSmithKline, included articles on the economic and health consequences of vaccinating against pneumococcal and haemophillus infections.

In the first study, the researchers used national estimates in order to determine the residual economic burden of pneumococcal and haemophilus infections following pneumococcal 7-valent CRM197 vaccine conjugate (PCV-7) vaccination in children under 10 years old in Canada, Germany, Mexico and Norway.2 They estimated direct and indirect costs (at 2008 values; converted to $US) and assumed full herd effect over 1 year.

The current annual national costs ranged from $2.59/capita in Mexico up to $7.89/capita in Canada. They found that because of the high incidence of otis media it accounted for up to 88% of national direct costs and up to 96% of caregiver costs for pneumococcal or haemophilus infections.

The researchers say that a strength of this study was that they included both direct medical and caregiver productivity loss costs for the diseases across each of the different countries, and that estimating these costs separately “gives decision makers a better understanding of how much of the cost burden is attributable” to these different factors.

The second study evaluated the cost effectiveness of haemophilus influenzae pneumococcal vaccine (PHiD-CV) compared with PCV-7 across the same four countries.3 This study used an adapted static population model in order to determine the costs and QALYs associated with each vaccine (2008 values were used in the local currency). The investigators also conducted a short-term analysis, with a separate module from the underlying population, where vaccination of a single birth cohort each year for 10 years was simulated.

They found that, when price parity was assumed, “routine vaccination with PHiD-CV resulted in lower costs compared with PCV-7 in both the short term and the steady-state year”. The cost savings were not so pronounced in the short-term analysis “but cost savings increased quickly after multiple birth cohorts were vaccinated”.

Dr Annemans says that analyses like these “illustrate well what country-specific data really mean”, highlighting that the differences observed between countries not only pertain to the epidemiology but the “management style, unit costs and quality-of-life impact”.