INTRODUCTION: Introduction of pneumococcal conjugate vaccines (PCV) to the Canadian childhood routine immunization schedules (RIS) resulted in significant benefits. The 7-valent PCV was added to all provinces’ RIS between 2002 and 2006. The 10-valent PCV was used in Ontario and Quebec for 12 to 18 months in 2009 and 2010. The 13-valent PCV was marketed in 2010 and rapidly adopted by all provinces by 2011. Direct vaccine protection reduced incidence of invasive pneumococcal disease (IPD), pneumonia (PNE) and acute otitis media (AOM) in vaccinated children. Indirect vaccine protection also reduced the burden of disease in other age groups. The objective of this study is to evaluate the economic impact of PCVs following nationwide RIS implementation.
RESEARCH METHODS: Canadian databases and literature were reviewed to obtain pre- and post-PCV incidence of IPD, PNE and AOM, as well as direct and indirect medical costs (reported in 2017 $ CAD). Case counting index date was set to Jan 2005, at which point PCV RIS were implemented for over 90% of children. A steady state scenario using pre-PCV incidence rates was projected to Dec 2015 to estimate the number of cases expected in the absence of PCVs. Averted cases were obtained by subtracting the cases reported from the estimated case count without PCVs. Disease costs were assigned to averted cases and vaccine spend was subtracted from the total to obtain net savings.
RESULTS AND ANALYSIS: Successive implementation of PCVs on the provinces’ RIS saved 9,767 lives and resulted in net savings of CAD $1.76 billion between Jan 2005 and Dec 2015. These savings stem from averted direct and indirect medical costs associated with IPD, PNE and AOM cases.
RECOMMEDATIONS AND IMPLICATIONS FOR PRACTICE: Introduction of PCVs resulted in reduced pneumococcal burden of disease and net economic benefits to Canadian society and sustained PCV funding will continue to accrue these benefits.
