Cost-Effectiveness and Budget Impact Analyses of Pneumococcal Vaccination in Indonesia

Table 1

Parameters used in the model.

Parameters	Baseline value	Reference
Epidemiology
Incidence rate of PP (children <5 years of age)	0.26	[20]
Incidence rate of IPD (children <5 years of age)	0.0045	[21]
Mortality rate of PP	3.78 per 1,000 live births	[21]
Case fatality rate of IPD	0.57	[22]
Duration of illness (days)	14.6
IPD hospitalized	7.9	[16, 26]
PP hospitalized	7.14
Nonbacteremic PP hospitalized	1
All outpatient cases
Utility losses
All outpatient cases	0.00002	[16, 26];
Nonbacteremic PP hospitalized	0.00016	Calculated
PP hospitalized	0.00017
IPD hospitalized	0.00092
All fatal cases	1.00000
Introduction strategy
Vaccination coverage	85% (increase 2.5% annually)	[20]
Vaccination schedule	2-3-12 months	[20]
Vaccine efficacy
PP	54.73% (PCV10); 72.93% (PCV13)	[23–25];
IPD	59.90% (PCV10); 79.81% (PCV13)	Calculated
Nonbacteremic PP	13.52% (PCV10); 18.02% (PCV13)
Healthcare cost
Outpatient	$0.63	Primary
Hospitalized	$59	Data
IPD hospitalized	$334	[29]
Societal cost
Outpatient	$2.65	[27]
Hospitalized	$135.20	[28]
IPD hospitalized	$810.00	[29]
Payer cost
Outpatient	$18.37	Reference [30];
Hospitalized	$288.22	Adjusted
IPD hospitalized	$301.80
Vaccination cost
PCV13 (UNICEF price)	$3.30	[31]
PCV10 (UNICEF price)	$3.05	[31]
PCV13 (government contract price)	$18.90	MoH
PCV10 (government contract price)	$17.45	Assumed
Waste disposal	25%	[32]
Administration cost	$0.50	[32]
Discount rate	3%	[33]

PP: pneumococcal pneumonia. IPD: invasive pneumococcal disease. Direct medical costs, direct and indirect costs, all costs covered by BPJS Kesehatan.