Sinha+Lancet+PCV+CEA+2007 - Articles Cost-eectiveness of...

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Articles Vol 369 February 3, 2007 389 Cost-ef ectiveness o± pneumococcal conjugate vaccination in the prevention o± child mortality: an international economic analysis Anushua Sinha, Orin Levine, Maria D Knoll, Farzana Muhib, Tracy A Lieu Summary Background Routine vaccination of infants against Streptococcus pneumoniae (pneumococcus) needs substantial investment by governments and charitable organisations. Policymakers need information about the projected health beneF ts, costs, and cost-e± ectiveness of vaccination when considering these investments. Our aim was to incorporate these data into an economic analysis of pneumococcal vaccination of infants in countries eligible for F nancial support from the Global Alliance for Vaccines & Immunization (GAVI). Methods We constructed a decision analysis model to compare pneumococcal vaccination of infants aged 6, 10, and 14 weeks with no vaccination in the 72 countries that were eligible as of 2005. We used published and unpublished data to estimate child mortality, e± ectiveness of pneumococcal conjugate vaccine, and immunisation rates. Findings Pneumococcal vaccination at the rate of diptheria–tetanus–pertussis vaccine coverage was projected to prevent 262 000 deaths per year (7%) in children aged 3–29 months in the 72 developing countries studied, thus averting 8·34 million disability-adjusted life years (DALYs) yearly. If every child could be reached, up to 407 000 deaths per year would be prevented. At a vaccine cost of International $5 per dose, vaccination would have a net cost of $838 million, a cost of $100 per DALY averted. Vaccination at this price was projected to be highly cost-e± ective in 68 of 72 countries when each country’s per head gross domestic product per DALY averted was used as a benchmark. Interpretation At a vaccine cost of between $1 and $5 per dose, purchase and accelerated uptake of pneumococcal vaccine in the world’s poorest countries is projected to substantially reduce childhood mortality and to be highly cost-e± ective. Introduction Vaccination of infants in the world’s poorest countries against Streptococcus pneumoniae (pneumococcus) has the potential to prevent many deaths, but would need substantial funding. Pneumonia and other respiratory infections cause about 2 million child deaths yearly, nearly all in developing countries. 1 Most pneumonia deaths are believed to be due to bacterial pneumonia, 2 and S pneumoniae is the most common cause of bacterial pneumonia in infants and young children. 3 Additionally, pneumococcus often causes otitis media, bacteraemia, sepsis, and meningitis in early childhood. Experience with other vaccines suggests that, without substantial global investment and coordinated eF ort, a conjugated pneumococcal vaccine is unlikely to reach children in developing countries during the next decade.
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This note was uploaded on 02/08/2011 for the course ECONOMICS 101 taught by Professor June during the Spring '08 term at Rutgers.

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Sinha+Lancet+PCV+CEA+2007 - Articles Cost-eectiveness of...

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