OBJECTIVES:

The burden of pneumococcal diseases is considerably high in Asian countries with substantial incidence, mortality rates, and case-fatality ratios, especially in children. Pneumococcal conjugate vaccine (PCV) have shown to be safe and efficacious to prevent pneumococcal diseases. Yet, comprehensive review performed in this region to assess overall potential health and economic benefits of PCV remains limited. The aim of this study was to investigate health economic impact of PCV vaccination within Asian countries and its influencing factors.

METHODS:

Systematic search was conducted in two electronic databases (Pubmed and EMBASE) to identify eligible studies on economic evaluation of PCV vaccination in Asian countries. Only full papers written in English containing complete economic assessments in PCV vaccination were included.

RESULTS:

From 390 references screened, 19 studies were eligible for inclusion. The included studies were from 9 countries, including China (5), Malaysia (3), Korea (2), Philippines (2), Taiwan (2), Hongkong (2), Japan (1), Thailand (1), and Mongolia (1). 15 studies were classified as cost-effeciveness analysis (CEA), 3 studies performed cost-utility analysis (CUA), and 1 study consisted of CEA and budget impact analysis (BIA). All studies used modeling approach, including Markov model (11), decision tree model (7), and dynamic model (1). Regarding the perspectives, 9 studies used healthcare perspective, 4 studies used only societal perspective, and 6 studies used both perspectives. Majority of the studies (16) took into account indirect effect (herd effect) of the vaccination. Only 3 studies did not consider herd effect. 6 studies showed that PCV-10 is cost-saving (dominant) compared to PCV-13

CONCLUSIONS:

Our review indicated that the majority of pediatric PCV vaccination in Asian countries was considered cost-effective. Factors influencing the analysis among others are vaccine cost, vaccine coverage, indirect effect, the incidence of pneumonia, the incidence of AOM, recovery rate, and discount rate.