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Chen C, Cervero Liceras F, Flasche S, Sidharta S, Yoong J, Sundaram N, Jit M. Effect and cost-effectiveness of pneumococcal conjugate vaccination: a global modelling analysis. Lancet Glob Health 2018; 7:e58-e67. [PMID: 30554762 PMCID: PMC6293964 DOI: 10.1016/s2214-109x(18)30422-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 07/10/2018] [Accepted: 09/03/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Introduction of pneumococcal conjugate vaccines (PCVs) has substantially reduced disease burden due to Streptococcus pneumoniae, a leading cause of childhood morbidity and mortality globally. However, PCVs are among the most expensive vaccines, hindering their introduction in some settings and threatening sustainability in others. We aimed to assess the effect and cost-effectiveness of introduction of 13-valent PCV (PCV13) vaccination globally. METHODS We assessed the incremental cost-effectiveness ratio of PCV13 introduction by integrating two models: an ecological model (a parsimonious, mechanistic model validated with data from post-seven-valent PCV introduction in 13 high-income settings) to predict the effect of PCV on childhood invasive pneumococcal disease, and a decision-tree model to predict a range of clinical presentations and economic outcomes under vaccination and no-vaccination strategies. The models followed 30 birth cohorts up to age 5 years in 180 countries from 2015 to 2045. One-way scenario and probabilistic sensitivity analyses were done to explore model uncertainties. FINDINGS We estimate that global PCV13 use could prevent 0·399 million child deaths (95% credible interval 0·208 million to 0·711 million) and 54·6 million disease episodes (51·8 million to 58·1 million) annually. Global vaccine costs (in 2015 international dollars) of $15·5 billion could be partially offset by health-care savings of $3·19 billion (2·62 billion to 3·92 billion) and societal cost savings of $2·64 billion (2·13 billion to 3·28 billion). PCV13 use is probably cost-effective in all six UN regions. The 71 countries eligible for support from Gavi, the Vaccine Alliance, account for 83% of PCV13-preventable deaths but only 18% of global vaccination costs. The expected cost of PCV vaccination globally is around $16 billion per year. INTERPRETATION Our findings highlight the value of Gavi's support for PCV introduction in low-income countries and of efforts to improve the affordability of PCVs in countries not eligible for, or transitioning from, Gavi support. FUNDING World Health Organization; Gavi, the Vaccine Alliance; and the Bill & Melinda Gates Foundation.
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Affiliation(s)
- Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Stefan Flasche
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Sucitro Sidharta
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Joanne Yoong
- Center for Economic and Social Research, University of Southern California, Washington, DC, USA; Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
| | - Neisha Sundaram
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Jit
- Modelling and Economics Unit, Public Health England, London, UK,Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Sundaram N, Duckett K, Yung CF, Thoon KC, Sidharta S, Venkatachalam I, Chow A, Yoong J. “I wouldn’t really believe statistics” – Challenges with influenza vaccine acceptance among healthcare workers in Singapore. Vaccine 2018. [DOI: 10.1016/j.vaccine.2018.02.102] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Takata K, Shemesh T, Kim S, Duong M, Lyons J, Sidharta S, Brown A, Nicholls S. Associations of Cardiovascular Risk Factors With Cholesterol Efflux Capacity in Indigenous Australians. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Takata K, Honda S, Sidharta S, Duong M, Shishikura D, Kim S, Andrews J, Di Bartolo B, Butters J, Psaltis P, Worthley M, Nicholls S. P2334Association between cholesterol efflux capacity and coronary plaque lipid composition on near infrared spectroscopy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sidharta S, Baillie T, Howell S, Nicholls S, Montarello N, Honda S, Shishikura D, Delacroix S, Beltrame J, Psaltis P, Worthley S, Worthley M. P667In vivo evaluation of human coronary structure-function predicts subsequent progression of coronary atherosclerotic plaques: a near infrared spectroscopy study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chen C, Sidharta S, Koh W, Yuan J, Ma S, Heng D, Tan K, Yoong J. FORECASTING HOSPITAL UTILIZATION AND COST OF FUTURE ELDERLY IN SINGAPORE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C. Chen
- University of Southern California, Los Angeles, California,
- National University of Singapore, Singapore, Singapore
| | - S. Sidharta
- National University of Singapore, Singapore, Singapore
| | - W. Koh
- Duke NUS, Singapore, Singapore,
| | - J. Yuan
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - S. Ma
- Ministry of Health, Singapore, Singapore
| | - D. Heng
- Ministry of Health, Singapore, Singapore
| | - K. Tan
- Ministry of Health, Singapore, Singapore
| | - J. Yoong
- University of Southern California, Los Angeles, California,
- National University of Singapore, Singapore, Singapore
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Takata K, Honda S, Sidharta S, Duong M, Shishikura D, Kim S, Andrews J, Bartolo B, Nguyen T, Butters J, Psaltis P, Worthley M, Nicholls S. Relationship of Cholesterol Efflux Capacity with Coronary Plaque Lipid Composition on Near Infrared Spectroscopy. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Honda S, Sidharta S, Shishikura D, Takata K, DiGiovanni G, Potgieter C, Nguyen T, Jassan A, Kim S, Psaltis P, Andrews J, Worthley M, Nicholls S. Change in High-Density Lipoprotein Cholesterol in Relation to Serial Change in Coronary Plaque Lipid Burden Assessed by Near-Infrared Spectroscopy. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sidharta S, Baillie T, Montarello N, Montarello N, Beltrame J, Worthley S, Nicholls S, Worthley M. Relationship Between Human Coronary Endothelial Function and Lipid Rich Plaque (LRP) Burden. A Near-Infrared Spectroscopy (NIRS)/Grey Scale Intravascular Ultrasound (IVUS) Study. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sidharta S, Baillie T, Montarello N, Montarello N, Beltrame J, Worthley S, Nicholls S, Worthley M. Relationship Between Coronary Arterial Plaque Burden and Endothelium Independent Vasoreactivity: An Intravascular Ultrasound Study. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Baillie T, Teo K, Sidharta S, Worthley S, Sanders P, Steele P, Nicholls S, Worthley M. A novel non-invasive pulmonary vasoreactive challenge utilising cardiac magnetic resonance imaging: comparison of subjects with and without pulmonary arterial hypertension. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sheikh A, Sidharta S, Pasupathy S, Worthley M, Beltrame J. The importance of evaluating patients with MINOCA (Myocardial infarction with non-obstructive coronary arteries). Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shields C, Andrianopoulos N, Roberts L, Sidharta S, Duffy S, Ajani A, Sebastian M, Clark D, Brennan A, Loane P, Munnar K, Black A, New G. Does Thrombus Aspiration Improve Clinical Outcomes post Primary PCI? Insights from the Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sidharta S, Roberts L, Briganti E, Mirzaee S, John N, Mascaro J, Beale J, New G. Survival Following Out of Hospital VF Arrest Due to STEMI. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Childs W, Andrianopoulos N, Sidharta S, Roberts L, Duffy S, Ajani A, Lefkovits J, Clark D, Farouque O, Brennan A, Yip T, Munnur R, Martin L, Reid C, New G. Does Field-triage of STEMI Patients by Paramedics Improve Door-to-balloon Times and Clinical Outcomes in Infarct PCI?—Insights from the Melbourne Interventional Group (MIG) Registry. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Roberts L, Andrianopoulos N, Harries I, Moore M, Duffy S, Black A, Ajani A, Loane P, Brennan A, Ching S, Sapontis J, Childs W, Parnham S, Sidharta S, New G. Long-Term Outcomes and Predictors of Death and MACE Following PCI: Insights From the MIG Registry. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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