TY - JOUR T1 - Cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the universal immunisation of infants in Brazil JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 210 LP - 217 DO - 10.1136/jech.2010.111880 VL - 66 IS - 3 AU - Ana Marli Christovam Sartori AU - Patricia Coelho de Soárez AU - Hillegonda Maria Dutilh Novaes Y1 - 2012/03/01 UR - http://jech.bmj.com/content/66/3/210.abstract N2 - Background Cost-effectiveness studies have been increasingly part of decision processes for incorporating new vaccines into the Brazilian National Immunisation Program. This study aimed to evaluate the cost-effectiveness of 10-valent pneumococcal conjugate vaccine (PCV10) in the universal childhood immunisation programme in Brazil.Methods A decision-tree analytical model based on the ProVac Initiative pneumococcus model was used, following 25 successive cohorts from birth until 5 years of age. Two strategies were compared: (1) status quo and (2) universal childhood immunisation programme with PCV10. Epidemiological and cost estimates for pneumococcal disease were based on National Health Information Systems and literature. A ‘top-down’ costing approach was employed. Costs are reported in 2004 Brazilian reals. Costs and benefits were discounted at 3%.Results 25 years after implementing the PCV10 immunisation programme, 10 226 deaths, 360 657 disability-adjusted life years (DALYs), 433 808 hospitalisations and 5 117 109 outpatient visits would be avoided. The cost of the immunisation programme would be R$10 674 478 765, and the expected savings on direct medical costs and family costs would be R$1 036 958 639 and R$209 919 404, respectively. This resulted in an incremental cost-effectiveness ratio of R$778 145/death avoided and R$22 066/DALY avoided from the society perspective.Conclusion The PCV10 universal infant immunisation programme is a cost-effective intervention (1–3 GDP per capita/DALY avoided). Owing to the uncertain burden of disease data, as well as unclear long-term vaccine effects, surveillance systems to monitor the long-term effects of this programme will be essential. ER -