* My article in BusinessWorld, April 2, 2020.
Before the China virus — a.k.a. SARS-Cov-2 which causes
Covid-19 — scare, pneumococcal diseases caused by a bacteria called
Streptococcus pneumonia and their treatment were in the news. The bacteria can
affect people of all ages, from babies to senior citizens, and pneumococcal
diseases are a leading cause of death among children below five years old. When
the bacteria invade the lungs, they can cause pneumonia and death. They can
also invade the bloodstream and cause bacteremia, or invade the tissues and fluids
surrounding the brain and spinal cord and cause meningitis.
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The best way to combat the bacteria is pneumococcal
conjugate vaccine (PCV). The Department of Health (DoH) first procured PCV10 in
2012 — this vaccine protects against 10 strains of the bacteria. Then the DoH
shifted to tridecavalent PVC13 in 2014, which protects against 13 strains of
pneumococcal bacteria, after the World Health Organization (WHO)
cost-effectiveness studies showed that PCV13 is more cost-effective than PCV10.
PCV13 was then included in the Philippine National Formulary.
The three bacteria strains not covered by PCV10 are
serotypes 3, 6A, and 19A. Serotype 19A in particular is more serious, can lead
to meningitis, invasive diseases, and severe pneumonia. Pneumonia is estimated
to kill over 50,000 people in the Philippines yearly, the third most deadly
disease in the country.
An issue came out in late 2019 when some individuals or
groups questioned why PCV procurement — a total of P4.9 billion for 2020 —
specified only a single vaccine, PCV13.
I got curious about the difference between the two
vaccines, I made my own brief research and I found these four studies and
report (see Table 1).
So from a technical and medical perspective, PCV13 is
superior. From a financial and fiscal cost, PCV13 is more costly by about 10%.
An estimate of the fiscal cost if universal vaccination is done nationwide was
made in 2015, the only study I have encountered so far (see Table 2).
From this 2015 study, it comes to a difference of P2
billion over five years, or P400 million/year for vaccines of PCV13. Updated to
2020 costs this comes to about P500 million/year — but PCV13 will protect
thousands or millions of children from more virulent diseases. The DoH should
be guided more by thousands of children’s lives that will be saved, than the
extra cost of half a billion pesos that it can save.
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