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Author: Reyes López, María Cristina ; Gladys Fuentes, Gladys Abreu ; Donatién Rojas, Nordis Caridad ; Yanes Macías, Juan C. ; Gonzálvez Luis, Isabel Pilar ; Pérez, Alina ; Omeiri, Nathalie El ; Llul Tombo, Cary Tere ; Moraima ; García Rodríguez, Iliana ; Pérez Orta, Miosotis ; Paredes, Beatriz ; Justiz Hernández, Silvia ; Casanova, Maria F. ; Borroto Gutiérrez, Susana ; Maren González, María ; García-Rivera, Dagmar ; Rodriguez Fonseca, Amanda ; García Fariñas, Anai ; Reyes, Alaín ; Batista Caluff, Lissett ; Pajaro Medina, Magdevis ; Mirabal, Mayelín ; Clark, Andrew ; García, Malfran ; Cuza Ferrer, Mariela ; Infante, Concepción ; Áreas, Itciar ; Cuevas, Ivan ; de Oca, Martha Montes ; de Oca, Yaima Figueredo Montes ; Vega Mendoza, Dania ; Rodríguez Ortega, Misladys ; Rondón Peña, Bertha Isabel ; Marrero Araújo, Martha C. ; Chavez, Dunia ; Martínez, Marisel ; Maceira Soto, Samira ; López Ambrón, Lena ; Rodríguez, Meiby C. ; Valdés-Balbín, Yuri ; Ricardo, Yariser ; Mederos Reyes, Carlos ; Reyes Sebasco, Alain ; Velázquez Águila, Antonio ; Rondón Rondón, Luis Enrique ; Herrera López, Josefina ; Toraño Peraza, Gilda ; Rodríguez, Laura M. ; Toledo-Romaní, María Eugenia ; Cobas Limonta, Nivia ; Fonseca, Mercedes ; Guillén, José R. ; Díaz Teran, Daisy ; Janusz, Cara ; Rodríguez, Adriana ; Linares-Pérez, Nivaldo ; Molina Águila, Niurka ; Elena Mesa, Maria ; Teresita Ramos, Lidia ; María Gálvez, Ana ; Reyes Jiménez, Alicia ; Legarreta Peňa, Ernesto
OBJECTIVES:To evaluate the cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban National Immunization Program (NIP).
METHODS:We compared PCV7-TT given at two, four and six months of age to a scenario without PCV7-TT, over a ten-year period (2020-2029). We calculated the cost (Cuban pesos - CUP) per Disability Adjusted Life Year (DALY) averted from a Government perspective. We compared results from a static cohort model and a parsimonious prediction model informed by the serotype distribution among pneumococcal carriers and cases. We ran probabilistic and deterministic uncertainty analyses.
RESULTS:PCV7-TT could prevent 6897 (95% uncertainty interval, 4344-8750) hospitalizations and 189 (115-253) deaths in children <5 years of age, over the period 2020-2029. This could cost around 25 million (20-31) discounted CUP but would be offset by treatment cost savings of around 23 million (14-31). A parsimonious model predicted less favourable impact and cost-effectiveness but the cost per DALY averted was still less than 0.4 times the current GDP per capita.
CONCLUSIONS:PCV7-TT is likely to be cost-effective in Cuba. The impact of the vaccine would need to be carefully monitored following its introduction into the NIP.