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作者: Batista Caluff, Lissett ; Infante, Concepción ; de Oca, Martha Montes ; Cobas Limonta, Nivia ; Rondón Rondón, Luis Enrique ; Molina Águila, Niurka ; Pérez, Alina ; Martínez, Marisel ; Moraima ; Reyes Sebasco, Alain ; Herrera López, Josefina ; Legarreta Peňa, Ernesto ; Linares-Pérez, Nivaldo ; Guillén, José R. ; Gonzálvez Luis, Isabel Pilar ; Pérez Orta, Miosotis ; Mederos Reyes, Carlos ; Cuza Ferrer, Mariela ; Pajaro Medina, Magdevis ; Marrero Araújo, Martha C. ; García-Rivera, Dagmar ; Omeiri, Nathalie El ; Justiz Hernández, Silvia ; Velázquez Águila, Antonio ; Rodríguez Ortega, Misladys ; Yanes Macías, Juan C. ; García Rodríguez, Iliana ; de Oca, Yaima Figueredo Montes ; Rodríguez, Laura M. ; Díaz Teran, Daisy ; Gladys Fuentes, Gladys Abreu ; Fonseca, Mercedes ; Reyes López, María Cristina ; Vega Mendoza, Dania ; García Fariñas, Anai ; Clark, Andrew ; Rondón Peña, Bertha Isabel ; Reyes, Alaín ; Teresita Ramos, Lidia ; Rodríguez, Adriana ; Toraño Peraza, Gilda ; Toledo-Romaní, María Eugenia ; Donatién Rojas, Nordis Caridad ; Mirabal, Mayelín ; Áreas, Itciar ; Cuevas, Ivan ; Janusz, Cara ; Valdés-Balbín, Yuri ; Reyes Jiménez, Alicia ; Borroto Gutiérrez, Susana ; Maceira Soto, Samira ; Maren González, María ; García, Malfran ; Chavez, Dunia ; Llul Tombo, Cary Tere ; López Ambrón, Lena ; María Gálvez, Ana ; Ricardo, Yariser ; Casanova, Maria F. ; Elena Mesa, Maria ; Rodríguez, Meiby C. ; Paredes, Beatriz ; Rodriguez Fonseca, Amanda
OBJECTIVESTo evaluate the cost-effectiveness of introducing a domestic pneumococcal conjugate vaccine (PCV7-TT) into the Cuban National Immunization Program (NIP).METHODSWe compared PCV7-TT given at two, four and six months of age to a scenario without PCV7-TT, over a ten-year period (2020-2029). We calculated the cost (Cuban pesos - CUP) per Disability Adjusted Life Year (DALY) averted from a Government perspective. We compared results from a static cohort model and a parsimonious prediction model informed by the serotype distribution among pneumococcal carriers and cases. We ran probabilistic and deterministic uncertainty analyses.RESULTSPCV7-TT could prevent 6897 (95% uncertainty interval, 4344-8750) hospitalizations and 189 (115-253) deaths in children <5 years of age, over the period 2020-2029. This could cost around 25 million (20-31) discounted CUP but would be offset by treatment cost savings of around 23 million (14-31). A parsimonious model predicted less favourable impact and cost-effectiveness but the cost per DALY averted was still less than 0.4 times the current GDP per capita.CONCLUSIONSPCV7-TT is likely to be cost-effective in Cuba. The impact of the vaccine would need to be carefully monitored following its introduction into the NIP.