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Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone

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  • Gizem M Bilgin
  • Syarifah Liza Munira
  • Kamalini Lokuge
  • Kathryn Glass

Abstract

Maternal pneumococcal vaccines have been proposed as a method of protecting infants in the first few months of life. In this paper, we use results from a dynamic transmission model to assess the cost-effectiveness of a maternal pneumococcal polysaccharide vaccine from both healthcare and societal perspectives. We estimate the costs of delivering a maternal pneumococcal polysaccharide vaccine, the healthcare costs averted, and productivity losses avoided through the prevention of severe pneumococcal outcomes such as pneumonia and meningitis. Our model estimates that a maternal pneumococcal program would cost $606 (2020 USD, 95% prediction interval 437 to 779) from a healthcare perspective and $132 (95% prediction interval -1 to 265) from a societal perspective per DALY averted for one year of vaccine delivery. Hence, a maternal pneumococcal vaccine would be cost-effective from a societal perspective but not cost-effective from a healthcare perspective using Sierra Leone’s GDP per capita of $527 as a cost-effectiveness threshold. Sensitivity analysis demonstrates how the choice to discount ongoing health benefits determines whether the maternal pneumococcal vaccine was deemed cost-effective from a healthcare perspective. Without discounting, the cost per DALY averted would be $292 (55% of Sierra Leone’s GDP per capita) from a healthcare perspective. Further, the cost per DALY averted would be $142 (27% GDP per capita) from a healthcare perspective if PPV could be procured at the same cost relative to PCV in Sierra Leone as on the PAHO reference price list. Overall, our paper demonstrates that maternal pneumococcal vaccines have the potential to be cost-effective in low-income settings; however, the likelihood of low-income countries self-financing this intervention will depend on negotiations with vaccine providers on vaccine price. Vaccine price is the largest program cost driving the cost-effectiveness of a future maternal pneumococcal vaccine.

Suggested Citation

  • Gizem M Bilgin & Syarifah Liza Munira & Kamalini Lokuge & Kathryn Glass, 2023. "Cost-effectiveness analysis of a maternal pneumococcal vaccine in low-income, high-burden settings such as Sierra Leone," PLOS Global Public Health, Public Library of Science, vol. 3(8), pages 1-14, August.
  • Handle: RePEc:plo:pgph00:0000915
    DOI: 10.1371/journal.pgph.0000915
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    1. Hannah Christensen & Hareth Al-Janabi & Pierre Levy & Maarten J. Postma & David E. Bloom & Paolo Landa & Oliver Damm & David M. Salisbury & Javier Diez-Domingo & Adrian K. Towse & Paula K. Lorgelly & , 2020. "Economic evaluation of meningococcal vaccines: considerations for the future," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 297-309, March.
    2. Saba Abidi & Satyanarayana Labani & Aastha Singh & Smita Asthana & Puneeta Ajmera, 2020. "Economic evaluation of human papillomavirus vaccination in the Global South: a systematic review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(7), pages 1097-1111, September.
    3. Sophie Witter & Nouria Brikci & Tim Harris & Richard Williams & Sarah Keen & Ana Mujica & Alex Jones & Alex Murray‐Zmijewski & Barbara Bale & Bailah Leigh & Ade Renner, 2018. "The free healthcare initiative in Sierra Leone: Evaluating a health system reform, 2010‐2015," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(2), pages 434-448, April.
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