Table 3.
Scenario analyses results for total direct costs, total quality-adjusted life-years gained, incremental difference between PCV13 and PCV10, and the cost-effectiveness of PCV13 compared with PCV10 Brazil national immunization program
| PCV13 |
PCV10 |
PCV13 vs PCV10 |
PCV13 vs PCV10 |
||||
|---|---|---|---|---|---|---|---|
| Scenario Analysis Conducted | Total Cost ($BRL) |
Total QALY | Total Cost ($BRL) | Total QALY | Cost Difference | QALY Difference | ICER |
| Base Case | $3,030,394,523 | 765,872,165 | $3,202,495,604 | 765,851,848 | -$172,101,081 | 20,317 | Cost-saving |
| IPD incidence using Chile cases | $2,775,818,677 | 765,921,572 | $2,792,646,977 | 765,916,820 | -$16,828,300 | 4,752 | Cost-saving |
| IPD incidence using Brazil cases | $2,690,940,597 | 765,943,240 | $2,819,482,762 | 765,924,284 | -$128,542,165 | 18,956 | Cost-saving |
| PCV13 trend using UK historical | $3,125,010,042 | 765,863,362 | $3,202,495,604 | 765,851,848 | -$77,485,562 | 11,514 | Cost-saving |
| PCV13 trend using Canada historical | $3,056,837,665 | 765,870,216 | $3,202,495,604 | 765,851,848 | -$145,657,940 | 18,368 | Cost-saving |
| PCV13 trend using Quebec historical | $3,050,404,341 | 765,865,766 | $3,202,495,604 | 765,851,848 | -$152,091,263 | 13,918 | Cost-saving |
| Excluding long-term sequelae | $2,925,050,221 | 765,874,302 | $3,072,430,995 | 765,854,486 | -$147,380,773 | 19,816 | Cost-saving |
| 10% of all-cause OM due to S. pn. | $3,020,361,038 | 765,872,326 | $3,189,103,635 | 765,852,063 | -$168,742,597 | 20,263 | Cost-saving |
| 10% of all-cause PNA due to S. pn. | $2,695,340,776 | 765,911,344 | $2,800,104,584 | 765,894,716 | -$104,763,808 | 16,628 | Cost-saving |
| Alternative case-fatality rates | $3,030,336,396 | 765,860,502 | $3,202,416,606 | 765,838,668 | -$172,080,211 | 21,834 | Cost-saving |
| Alternative vaccine coverage 89% | $2,902,979,885 | 765,872,165 | $3,078,800,341 | 765,851,848 | -$175,820,457 | 20,317 | Cost-saving |
| Ten-year time horizon | $5,436,117,048 | 1,284,387,358 | $6,027,867,541 | 1,284,295,364 | -$591,750,493 | 91,994 | Cost-saving |
| Discount rate set to 1% | $3,395,749,417 | 957,823,186 | $3,596,488,854 | 957,795,898 | -$200,739,437 | 27,288 | Cost-saving |
Abbreviations: BRL = Brazilian Real; ICER = incremental cost-effectiveness ratio; IPD = invasive pneumococcal disease; OM = otitis media; PCV10 = 10-valent pneumococcal conjugate vaccine; PCV13 = 13-valent pneumococcal conjugate vaccine; PNA = pneumonia; S. pn. = Streptococcus pneumoniae; QALY = quality-adjusted life-year; UK = United Kingdom.