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The pneumococcal vaccine is too expensive to be introduced into the childhood schedule despite evidence it would save lives and prevent thousands of hospitalisations, researchers conclude.

The price of the vaccine would need to be halved before its introduction could be cost-effective, according to an economic analysis submitted to Government advisers by the Health Protection Agency.

The RCGP has demanded the Government negotiates a lower price with manufacturer Wyeth as fears grow that the cost implications could block the vaccine's introduction.

Immunising infants in a three-dose schedule would prevent 63,000 GP consultations, 1,890 hospital admissions and 14 deaths a year, and save the NHS £4 million, the HPA study found. But at an estimated bulk price of £30 per vaccine, the programme would cost an unacceptable £113,231 per life year gained.

Study leader Dr John Edmunds, a health economist at the HPA, said: 'Ignoring potential herd-immunity effects, universal vaccination of children with the pneumococcal conjugate vaccine is not likely to be deemed cost-effective from the NHS perspective at the current price of the


'The latter should be set at around £10-£15 per dose in order to get a cost per quality of life year gained of approximately £30,000.'

The Joint Committee on Vaccination and Immunisation has indicated it would like to see routine pneumococcal

vaccination (see box), but is awaiting more convincing data on its economic viability.

Dr George Kassianos, RCGP immunisation spokesman and a GP in Bracknell, Berkshire, said: 'The question is not whether the Department of Health will introduce the conjugate pneumococcal vaccine for our children but when.

'If what deters the department from introducing it is the vaccine's current single unit price, we hope they are in business negotiations with the suppliers for a price that will allow primary care to embark on a campaign to immunise our children against this dreadful disease.'

Wyeth insisted its vaccine was cost-effective at current prices once herd immunity was taken into account.

The study was published in Vaccine (October).

Pneumococcal vaccination: the ups and downs

September 2002

The Government's head of immunisation, Dr David Salisbury, tells Pulse that introduction of pneumococcal vaccine is top of the list of priorities and has been proved to be effective

June 2003

A Government adviser admits introduction of the vaccine has been delayed by hysteria over MMR

May 2004

Hopes for introduction are raised as the JCVI recommends a two-dose schedule of the conjugate vaccine with a booster at 12 months to tie in with meningitis C campaign

August 2004

A 20-year UK surveillance study predicts universal pneumococcal vaccination would substantially cut mortality and morbidity

October 2004

Research from the Health Protection Agency suggests introducing the vaccine would not be cost-effective

By Brian Kelly

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