MANDATORY PNEUMOCOCCAL VACCINATION AND ITS IMPACT ON HEALTH CARE BUDGET

Aim: To evaluate the budget impact of the vaccination of children with either 10 or 13-valent conjugated pneumococcal vaccine (PCV10 and PCV13) in light of the new clinical evidences of efficacy. Methods: The perspective is that of the healthcare system for the period in which the main clinical outcomes were reportedthat is 4 years after the immunization. A systematic review of available publications on the clinical efficacy and budget impact analyses of the two vaccines was conducted. The efficacy was measures as an overall percentage of prevented cases for the main groups of invasive pneumococcal diseases (IPDs), community acquired pneumonia (CAP) and acute otitis media (AOM).Direct medical costs at macro level of the health care system have been calculated. The cost of infections therapy was multiplied by the expected number of patients after the immunization with either 10 or 13-valent vaccine, and the difference between the twocosts was derived. Results: The results show that the vaccination with 10 valent vaccine saves among 7000 BGN in case of meningitis and 2 mln BGN in case of otitis.This study confirms that the vaccination with PCV10 is cost saving for the Bulgarian healthcare system owing to its higher effectiveness and the savings generated from the lower number of expected cases of infections. Although the vaccination with the 13-valent vaccine ensures larger coverage against IPD caused by vaccine serotypes, its cost saving was not proven within national