A. Paternina

Systematic review of incremental non-vaccine cost estimates used in cost-effectiveness analysis on the introduction of rotavirus and pneumococcal vaccines

OBJECTIVE To review the approaches used in the cost-effectiveness analysis (CEAs) literature to estimate the cost of expanded program on immunization (EPI) activities, other than vaccine purchase, for rotavirus and pneumococcal vaccines. METHODS A systematic review in PubMed and NHS EED databases of rotavirus and pneumococcal vaccines CEAs was done. Selected articles were read and information on how EPI costs were calculated was extracted. EPI costing approaches were classified according to the method or assumption used for estimation. RESULTS Seventy-nine studies that evaluated cost effectiveness of rotavirus (n=43) or pneumococcal (n=36) vaccines were identified. In general, there are few details on how EPI costs other than vaccine procurement were estimated. While 30 studies used some measurement of that cost, only one study on pneumococcal vaccine used a primary cost evaluation (bottom-up costing analysis) and one study used a costing tool. Twenty-seven studies (17 on rotavirus and 10 on pneumococcal vaccine) assumed the non-vaccine costs. Five studies made no reference to additional costs. Fourteen studies (9 rotavirus and 5 pneumococcal) did not consider any additional EPI cost beyond vaccine procurement. For rotavirus studies, the median for non-vaccine cost per dose was US

Cost-effectiveness of the introduction of the pneumococcal polysaccharide vaccine in elderly Colombian population

0.74 in developing countries and US

The effect of guideline variations on the implementation of active management of the third stage of labor

6.39 in developed countries. For pneumococcal vaccines, the median for non-vaccine cost per dose was US

Impacto epidemiológico y económico de la vacunación contra el tétanos en adultos de Colombia

1.27 in developing countries and US

O690 ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOR: ARE INTERNATIONAL GUIDELINES USED IN CLINICAL PRACTICE?

8.71 in developed countries. CONCLUSIONS Many pneumococcal (52.8%) and rotavirus (60.4%) cost-effectiveness analyses did not consider additional EPI costs or used poorly supported assumptions. Ignoring EPI costs in addition to those for vaccine procurement in CEA analysis of new vaccines may lead to significant errors in the estimations of ICERs since several factors like personnel, cold chain, or social mobilization can be substantially affected by the introduction of new vaccines.

Clinical Characteristics and Outcomes of Obstetric Patients Requiring Mechanical Ventilation in Colombia

BACKGROUND Streptococcus pneumoniae causes community-acquired pneumonia, otitis media and meningitis, with higher incidences at the extremes of life. PPV-23 vaccine is widely used in prevention of pneumonia and invasive pneumococcal disease in older adults in developed countries. We developed an evaluation of cost-effectiveness of implementing PPV-23 in Colombian population over 60 years. METHODS The number of cases of pneumonia and meningitis in patients over 60 years and the proportion by S. pneumoniae was estimated based on a review of literature. A decision tree model with a 5-year time horizon was built to evaluate the cost-effectiveness of the implementation of the PPV-23 in this population. Direct health care costs of out- and in-patients were calculated based on expenditure records from the Bogota public health system. Incremental cost-effectiveness ratios per life saved and per year of life gained were estimated based on the decision tree model. Deterministic and probabilistic sensitivity analyses were performed. RESULTS Without vaccination 4460 (range 2384-8162) bacteremic pneumococcal pneumonias and 141 (range 73-183) pneumococcal meningitis would occur among people over 60 years old in Colombia. In the first year, vaccination with PPV-23 at US

PIN22 COST-EFFECTIVENESS OF A CATCH-UP DOSE OF HEPATITIS B VACCINE IN COLOMBIAN ADOLESCENTS

8/dose would save 480 (range 100-1753) deaths due to Invasive and non-invasive pneumococcal disease. Vaccination would results in US

PIN23 COST-EFFECTIVENESS OF PNEUMOCOCCAL VACCINE POLYVALENT (PPSV23) IN ADULTS OLDER THAN 60 YEARS OLD IN COLOMBIA

3400/deaths averted (range US

PRM18 Review of Administration's Cost Assumption of Rotavirus and Pneumococcal Vaccines Cost-Effectiveness Analyses

1028-10,862) and US

Acute Respiratory Failure as a Cause of Maternal Mortality in Colombia: An 11-Year Retrospective Study

1514/life years gained (range US