PT  - JOURNAL ARTICLE
AU  - Ana Marli Christovam Sartori
AU  - Patricia Coelho de Soárez
AU  - Hillegonda Maria Dutilh Novaes
TI  - Cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the universal immunisation of infants in Brazil
AID  - 10.1136/jech.2010.111880
DP  - 2012 Mar 01
TA  - Journal of Epidemiology and Community Health
PG  - 210--217
VI  - 66
IP  - 3
4099  - http://jech.bmj.com/content/66/3/210.short
4100  - http://jech.bmj.com/content/66/3/210.full
SO  - J Epidemiol Community Health2012 Mar 01; 66
AB  - 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.