International Journal of Community Medicine and Public Health | February 2020 | Vol 7 | Issue 2 Page 463 International Journal of Community Medicine and Public Health Idris IO et al. Int J Community Med Public Health. 2020 Feb;7(2):463-474 http://www.ijcmph.com pISSN 2394-6032 | eISSN 2394-6040 Original Research Article A health benefit and cost-effectiveness analysis of pneumococcal conjugate vaccination program in Nigeria Israel O. Idris 1-3 *, Okiki O. Badejo 4 , Victor Ochagu 2 , Sheriff A. Lamidi 5 , Nataliia Gavkalova 3 INTRODUCTION More than 60% of pneumonia deaths in Sub-Saharan Africa occur in children under five years, while about 86% of pneumonia deaths in the high-income region are among adults aged over 70 years. 1 Nigeria remains top, followed by the Democratic Republic of Congo, Ethiopia, Tanzania, South Africa and Kenya. 2 Pneumococcal diseases remain a public health concern in Nigeria. Nigeria accounts for the highest pneumonia disease 1 Department of Disease Control, Faculty of Epidemiology and Population Health, 2 Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom 3 Department of Public Administration, Kharkiv National University of Economics, Kharkiv, Ukraine 4 Department of Public Health, Institute of Tropical Medicine (ITM) Antwerp, University of Antwerp, Belgium 5 Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria Received: 03 January 2020 Revised: 21 January 2020 Accepted: 22 January 2020 *Correspondence: Dr. Israel O. Idris, E-mail: Israel.idris1@alumni.lshtm.ac.uk Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Nigeria ranks third just behind India and China in the global disease burden of pneumococcal disease. The current sustainability approach for an affordable pneumococcal conjugate vaccine (PCV) for the national immunization program from 2014 till 2025 involves a cost sharing plan funded with a 75% financial support from GAVI and a subsidy from Pfizer pharmaceuticals. There is a strong need to generate evidence on the cost- effectiveness of the national PCV program in Nigeria from 2014-2025 and beyond 2025. Methods: The following parameters (demography, disease burden, health services utilization and costs, vaccination coverage, vaccine efficacy, and vaccination costs) were used in a static cohort model to estimate the total cost, health and economic benefit, and cost-effectiveness of the implementation of PCV vaccination program, compared with no PCV vaccination among under-five children in Nigeria from 2014-2025 and from 2026-2033. A sensitivity analysis was conducted to evaluate the robustness of the data used. Results: The national PCV vaccination program would have an approximated 31.4% and 30% reduction of the total burden of pneumococcal diseases over the period of 2014-2025 and 2026-2033 respectively. One-way sensitivity analysis reveals vaccine efficacy as most sensitive parameter followed by disease incidence rate and treatment cost. Removal and addition of DTP3 and 3+1 (measles vaccine) dose respectively resulted to a similar ICER from both. Conclusions: The estimated ICER suggests that the national PCV program in Nigeria will be cost-effective post 2025 era. In addition, it is recommended for policy-makers adoption considering the budget and equity impact of the intervention in Nigeria. Keywords: Cost-effectiveness analysis, Economic evaluation, Health benefit, Pneumococcal conjugate vaccine, Nigeria DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20200415