Which vaccine is better?

Health Secretary Enrique Ona: In appreciation of cost effectiveness. INQUIRER file photo

MANILA, Philippines–Which antipneumonia shot is really better?

An economic analysis of the pneumococcal conjugate vaccine 10 (PCV 10) and its more pricey version, the PCV 13, has shown that the latter helped avert an estimated 63,000 more cases of pneumococcal diseases than the former in 2012.

The PCV 13 also prevented 495 more deaths than the PCV 10, said Dr. Issa Alejandria, an infectious disease specialist and clinical epidemiologist at the UP College of Medicine, who made a comparative study of the two vaccines in terms of cost and efficacy following the controversy over the Department of Health’s (DOH’s) purchase of the vaccines two years ago.

The data showed that the PCV 10 averted 1,479 cases of invasive pneumococcal diseases, but PCV 13 prevented 1,858, or 379 more, cases, Alejandria told a health forum in Quezon City on Tuesday.

PCV 10 kept in check 26,096 cases of all-cause pneumonia but the PCV 13 version averted 8,044 more cases.

Health forum

The data also showed that PCV 13 prevented 54,675 more cases of acute otitis media (AOM) more than its cheaper counterpart, which helped fend off 140,107 cases of AOM.

PCV 10 averted 1,904 deaths from pneumococcal disease—the leading cause of mortality among children between 1 and 4 years old and the second among infants—but PCV 13 prevented 2,399, or 495 more.

“If you will look at the data, it shows that both are cost-effective but PCV 13 is highly cost-effective,” Alejandria said. “But the question is, how much is the budget,” she said.

Probed by NBI

In the market, PCV 10 costs P2,056, or P4,000, with the professional fee. The cost of PCV 13 is P3,545, or P5,500, including the doctor’s fee, she said. The government price of PCV 10 was pegged at P624, or P76 cheaper than PCV 13, she added.

Health Secretary Enrique Ona and Assistant Health Secretary Eric Tayag are being investigated by the National Bureau of Investigation over the allegedly dubious procurement of antipneumonia shots in 2012.

Ona, who went on a month-long leave reportedly to prepare a report on the matter for President Aquino, earlier explained that the DOH decided to buy the PCV 10 “in appreciation of cost effectiveness” as it was almost a dollar cheaper than the PCV 13, which cost $16.34 per unit.

Ona has explained that the cost of the first-time procurement of the PCV 10 in 2012 for the DOH’s expanded vaccination program was P833.6 million. The nationwide vaccination program is said to benefit 330,000 children.

“Choosing between the two is not really an easy decision because you also have to look at other factors. It’s not only the direct cost but also the indirect cost,” said Alejandria. The budget allocation for the vaccines was also an important component in the procurement.

“The price of the vaccine is an important factor to consider as well as the bargaining power and how this will be implemented… those are the factors that have to be considered after seeing the numbers,” she said.

She also cited the World Health Organization’s (WHO’s) position on the two vaccines. According to the WHO, both vaccines have “comparable safety and efficacy profiles” for the serotypes contained in the vaccines.

“The choice of the PCV vaccine depends on factors such as the vaccine serotypes compared to serotypes prevalent in the locally identified target groups, vaccine supply and cost-effectiveness considerations,” the WHO has stated.

Alejandria said that to consider “cost-effectiveness,” the benefits of the vaccine as well as its “relative value” to patients should also be regarded, not the price alone. “We should also look at the severity of the conditions that can be prevented,” she said.