The Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in Seven Chinese Cities
Abstract
:1. Introduction
2. Methods
2.1. Approach
2.2. Demographic Inputs
2.3. Epidemiologic Inputs
2.4. Vaccine Effectiveness
2.5. Direct Costs
2.6. Quality of Life
2.7. Analysis
3. Results
3.1. Base Case Results
3.2. Incidence Rate Analysis
3.3. DE-Only Scenario
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Incidence (per 100,000) | 0–2 | 2–4 | 5–17 | 18–34 | 35–49 | 50–64 | 65+ |
---|---|---|---|---|---|---|---|
Pneumococcal Bacteremia † [17,18,19,20,27,28,29] | 5.03 (1.40–10.20) | 5.75 (1.98–9.47) | 16.64 (0.48–48.81) | 4.81 (0.54–12.48) | 4.50 (0.24–12.59) | 3.54 (0.50–9.21) | 14.57 (0.57–36.00) |
Pneumococcal Meningitis † [17,18,19,20,27,28,29] | 2.49 (0.65–5.10) | 1.59 (0.31–4.73) | 5.14 (0.24–14.59) | 1.43 (0.12–3.83) | 1.41 (0.08–4.02) | 1.20 (0.09–3.41) | 2.37 (0.06–6.88) |
Pneumonia | |||||||
Inpatient † [18,19,20,27,28] | 8969 (2949–19,719) | 8740 (2681–19,710) | 4675 (334–13,027) | 788 (110–2116) | 497 (111–1190) | 656 (305–1221) | 2661 (1856–3700) |
Outpatient † [18,19,20] | 12,797 (1568–24,027) | 15,749 (1642–29,857) | 3644 (643–6646) | 771 (186–1355) | 662 (166–1158) | 1035 (138–1931) | 3405 (147–6663) |
Otitis Media | |||||||
Mild † [18,19,20] | 9147 (2.32–16,762) | 8746 (29.45–15,531) | 2002 (24.87–3978) | 626 (5.39–1247) | 767 (5.89–1528) | 948 (3.17–1892) | 1043 (1.63–2085) |
Moderate to Severe † [18,19,20] | 2793 (15.53–4472) | 2650 (105–3953) | 494 (98.43–889) | 72.16 (10.62–134) | 130 (8.39–252) | 174 (4.99–343) | 182 (2.19–361) |
† CHIRA 2013–2015 | |||||||
Pre-PCV13 Serotype Coverage | Base Case | ||||||
Pneumococcal Bacteremia [30] | 0.87 | ||||||
Pneumococcal Meningitis [30] | 0.87 | ||||||
Pneumonia | |||||||
Inpatient [31] | 0.92 | ||||||
Outpatient [31] | 0.92 | ||||||
Otitis Media | |||||||
Mild [32] | 0.82 | ||||||
Moderate to Severe [32] | 0.82 | ||||||
Case Fatality Ratio | 0–2 | 2–4 | 5–17 | 18–34 | 35–49 | 50–64 | 65+ |
Pneumococcal Bacteremia [17,33] | 0.04 | 0.01 | 0.05 | 0.05 | 0.06 | 0.06 | 0.06 |
Pneumococcal Meningitis [17,33] | 0.14 | 0.03 | 0.04 | 0.00 | 0.12 | 0.00 | 0.02 |
Inpatient Pneumonia [17,33] | 0.01 | 0.01 | 0.01 | 0.06 | 0.06 | 0.01 | 0.16 |
Direct Effects | 0–2 | 2–4 | |||||
Pneumococcal Bacteremia [34] | 0.94 | 0.94 | |||||
Pneumococcal Meningitis [34] | 0.94 | 0.94 | |||||
Pneumonia | |||||||
Inpatient [34,35] | 0.29 | 0.29 | |||||
Outpatient [34,35] | 0.07 | 0.07 | |||||
Otitis Media | |||||||
Mild [36] | 0.08 | 0.08 | |||||
Moderate to Severe [36] | 0.17 | 0.17 | |||||
INDIRECT EFFECT | 0–2 | 2–4 | 5–17 | 18–34 | 35–49 | 50–64 | 65+ |
Pneumococcal Bacteremia [14,37,38] | 0.64 | 0.64 | 0.53 | 0.32 | 0.32 | 0.18 | 0.12 |
Pneumococcal Meningitis [14,37,38] | 0.64 | 0.64 | 0.53 | 0.32 | 0.32 | 0.18 | 0.12 |
Inpatient Pneumonia [14,37,38] | 0.22 | 0.17 | 0.00 | 0.12 | 0.05 | 0.02 | 0.03 |
Direct Medical Costs | 0–2 | 2–4 | 5–17 | 18–34 | 35–49 | 50–64 | 65+ |
---|---|---|---|---|---|---|---|
Pneumococcal Bacteremia | |||||||
Tier 1 | ¥695 | ¥2450 | ¥542 | ¥408 | ¥901 | ¥1407 | ¥2147 |
National | ¥695 | ¥2450 | ¥542 | ¥408 | ¥901 | ¥1407 | ¥2147 |
Pneumococcal Meningitis | |||||||
Tier 1 | ¥377 | ¥87 | ¥321 | ¥3131 | ¥356 | ¥4640 | ¥13,587 |
National | ¥25,602 | ¥5315 | ¥6967 | ¥13,105 | ¥5988 | ¥9345 | ¥6427 |
Pneumonia | |||||||
Inpatient | |||||||
Tier 1 | ¥5470 | ¥3942 | ¥6030 | ¥11,372 | ¥29,034 | ¥17,567 | ¥31,486 |
National | ¥4618 | ¥3101 | ¥3348 | ¥5140 | ¥5090 | ¥7518 | ¥11,820 |
Outpatient | |||||||
Tier 1 | ¥232 | ¥233 | ¥271 | ¥433 | ¥538 | ¥566 | ¥639 |
National | ¥195 | ¥205 | ¥194 | ¥253 | ¥277 | ¥353 | ¥430 |
Otitis Media | |||||||
Mild | |||||||
Tier 1 | ¥69 | ¥117 | ¥123 | ¥214 | ¥246 | ¥376 | ¥312 |
National | ¥144 | ¥114 | ¥116 | ¥166 | ¥167 | ¥209 | ¥174 |
Moderate to Severe | |||||||
Tier 1 | ¥2269 | ¥3221 | ¥3050 | ¥3769 | ¥3143 | ¥4768 | ¥3569 |
National | ¥2269 | ¥3221 | ¥3050 | ¥3769 | ¥3143 | ¥4768 | ¥3569 |
Source: CHIRA 2013–2015 |
TIER-1 CITIES | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Beijing | Shanghai | Shenzhen | ||||||||||
VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | ||||
Cases of Pneumococcal Disease 1 | ||||||||||||
Pneumococcal Bacteremia | 0.86 | 1.18 | −0.33 | 1.16 | 1.61 | −0.45 | 0.43 | 0.65 | −0.22 | |||
Pneumococcal Meningitis | 0.23 | 0.33 | −0.10 | 0.31 | 0.44 | −0.13 | 0.13 | 0.20 | −0.07 | |||
Pneumonia (Inpatient) | 248.80 | 283.21 | −34.41 | 326.51 | 361.70 | −35.19 | 136.24 | 153.68 | −17.44 | |||
Pneumonia (Outpatient) | 345.32 | 350.96 | −5.63 | 423.44 | 428.60 | −5.16 | 167.06 | 169.60 | −2.54 | |||
Otitis Media (Mild) | 69.28 | 72.83 | −3.55 | 63.47 | 66.72 | −3.25 | 31.22 | 32.82 | −1.60 | |||
Otitis Media (Mod./Sev.) | 19.82 | 22.13 | −2.31 | 18.16 | 20.28 | −2.12 | 8.93 | 9.97 | −1.04 | |||
Total Cases | 684.31 | 730.64 | −46.33 | 833.05 | 879.35 | −46.29 | 344.01 | 366.92 | −22.91 | |||
Total Deaths | 12.74 | 13.56 | −0.82 | 17.27 | 18.32 | −1.05 | 4.30 | 4.75 | −0.45 | |||
Total QALYs Lost | 135.95 | 147.96 | −12.01 | 181.87 | 196.75 | −14.88 | 66.20 | 73.86 | −7.66 | |||
Costs 2 | ||||||||||||
Vaccine Cost | ¥331.06 | ¥0.00 | ¥331.06 | ¥295.11 | ¥0.00 | ¥295.11 | ¥149.19 | ¥0.0 | ¥149.19 | |||
Pneumococcal Bacteremia | ¥1.01 | ¥1.30 | −¥0.30 | ¥1.36 | ¥1.74 | −¥0.38 | ¥0.30 | ¥0.45 | −¥0.15 | |||
Pneumococcal Meningitis | ¥0.96 | ¥1.16 | −¥0.19 | ¥1.29 | ¥1.55 | −¥0.26 | ¥0.28 | ¥0.37 | −¥0.09 | |||
Pneumonia (Inpatient) | ¥3706.33 | ¥3979.43 | −¥273.11 | ¥4966.81 | ¥5282.32 | −¥315.51 | ¥1461.90 | ¥1598.34 | −¥136.44 | |||
Pneumonia (Outpatient) | ¥140.62 | ¥141.93 | −¥1.31 | ¥179.26 | ¥180.46 | −¥1.20 | ¥59.07 | ¥59.66 | −¥0.59 | |||
Otitis Media (Mild) | ¥46.40 | ¥46.75 | −¥0.35 | ¥58.79 | ¥59.10 | −¥0.32 | ¥20.94 | ¥21.10 | −¥0.16 | |||
Otitis Media (Mod./Sev.) | ¥157.75 | ¥164.40 | −¥6.65 | ¥188.84 | ¥194.93 | −¥6.09 | ¥76.32 | ¥79.32 | −¥3.00 | |||
Total Cost | ¥4384.13 | ¥4334.97 | ¥49.16 | ¥5691.46 | ¥5720.11 | −¥28.65 | ¥1768.01 | ¥1759.24 | ¥8.76 | |||
ICER | ¥4093 | DOMINANT | ¥1145 | |||||||||
Other Cities | ||||||||||||
Chengdu | Karamay | Qingdao | Suzhou | |||||||||
VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | |
Cases of Pneumococcal Disease 1 | ||||||||||||
Pneumococcal Bacteremia | 0.80 | 1.13 | −0.34 | 0.02 | 0.03 | −0.01 | 0.43 | 0.62 | −0.19 | 0.51 | 0.73 | −0.22 |
Pneumococcal Meningitis | 0.21 | 0.32 | −0.10 | 0.01 | 0.01 | 0.00 | 0.12 | 0.17 | −0.06 | 0.14 | 0.21 | −0.07 |
Pneumonia (Inpatient) | 241.40 | 266.76 | −25.36 | 6.73 | 7.54 | −0.81 | 136.13 | 152.15 | −16.02 | 152.21 | 168.37 | −16.16 |
Pneumonia (Outpatient) | 304.27 | 308.25 | −3.98 | 8.63 | 8.77 | −0.14 | 176.60 | 179.28 | −2.68 | 190.24 | 192.62 | −2.38 |
Otitis Media (Mild) | 49.00 | 51.51 | −2.51 | 1.69 | 1.78 | −0.09 | 32.94 | 34.63 | −1.69 | 29.29 | 30.79 | −1.50 |
Otitis Media (Mod./Sev.) | 14.02 | 15.65 | −1.63 | 0.48 | 0.54 | −0.06 | 9.43 | 10.52 | −1.10 | 8.38 | 9.36 | −0.98 |
Total Cases | 609.69 | 643.61 | −33.92 | 17.56 | 18.67 | −1.10 | 355.65 | 377.37 | −21.72 | 380.78 | 402.08 | −21.30 |
Total Deaths | 11.16 | 11.84 | −0.68 | 0.26 | 0.28 | −0.02 | 6.14 | 6.51 | −0.38 | 7.01 | 7.47 | −0.46 |
Total QALYs Lost | 119.53 | 129.24 | −9.71 | 3.03 | 3.30 | −0.27 | 65.12 | 70.55 | −5.43 | 78.79 | 85.66 | −6.87 |
Costs 2 | ||||||||||||
Vaccine Cost | ¥235.76 | ¥0.00 | ¥235.76 | ¥7.80 | ¥0.00 | ¥7.80 | ¥159.37 | ¥0.00 | ¥159.37 | ¥139.00 | ¥0.00 | ¥139.00 |
Pneumococcal Bacteremia | ¥0.89 | ¥1.17 | −¥0.28 | ¥0.02 | ¥0.03 | −¥0.01 | ¥0.50 | ¥0.65 | −¥0.16 | ¥0.54 | ¥0.72 | −¥0.17 |
Pneumococcal Meningitis | ¥1.82 | ¥2.71 | −¥0.89 | ¥0.05 | ¥0.07 | −¥0.03 | ¥0.99 | ¥1.49 | −¥0.50 | ¥1.23 | ¥1.82 | −¥0.59 |
Pneumonia (Inpatient) | ¥1358.27 | ¥1473.49 | −¥115.21 | ¥34.69 | ¥38.19 | −¥3.50 | ¥763.06 | ¥834.15 | −¥71.09 | ¥844.59 | ¥918.43 | −¥73.84 |
Pneumonia (Outpatient) | ¥82.22 | ¥83.02 | −¥0.80 | ¥2.20 | ¥2.23 | −¥0.03 | ¥47.23 | ¥47.77 | −¥0.54 | ¥51.01 | ¥51.49 | −¥0.48 |
Otitis Media (Mild) | ¥29.69 | ¥30.00 | −¥0.32 | ¥0.85 | ¥0.86 | −¥0.01 | ¥16.96 | ¥17.17 | −¥0.21 | ¥18.94 | ¥19.13 | −¥0.19 |
Otitis Media (Mod./Sev.) | ¥135.57 | ¥140.27 | −¥4.70 | ¥3.97 | ¥4.13 | −¥0.16 | ¥79.35 | ¥82.51 | −¥3.16 | ¥84.39 | ¥87.20 | −¥2.81 |
Total Cost | ¥1844.21 | ¥1730.66 | ¥113.55 | ¥49.58 | ¥45.52 | ¥4.06 | ¥1067.45 | ¥983.74 | ¥83.71 | ¥1139.71 | ¥1078.79 | ¥60.92 |
ICER | ¥11,693 | ¥15,132 | ¥15,422 | ¥8862 |
Cities | Vaccination Rate | Price per Dose | Service/Transplantation FEE/DOSE | Vaccination Doses | ICER | GDP per Capita | ICER/GDP | Cost-Effective? |
---|---|---|---|---|---|---|---|---|
Beijing | 70% | ¥698 | ¥25 | 4 | ¥4093 | ¥164,000(2019) | 0.025 | Yes |
3 | Dominant | ----- | Yes | |||||
Shanghai | 70% | ¥698 | ¥5.5 | 4 | Dominant | ¥157,300 (2019) | ----- | Yes |
3 | Dominant | ----- | Yes | |||||
Shenzhen | 70% | ¥698 | ¥25 | 4 | ¥1145 | ¥203,489(2019) | 0.006 | Yes |
3 | Dominant | ----- | Yes | |||||
Chengdu | 70% | ¥698 | ¥30 | 4 | ¥11,693 | ¥103,386 (2019) | 0.113 | Yes |
3 | ¥5624 | 0.054 | Yes | |||||
Karamay | 70% | ¥698 | ¥0 | 4 | ¥15,132 | ¥145,798 (2017) | 0.104 | Yes |
3 | ¥7870 | 0.054 | Yes | |||||
Qingdao | 70% | ¥698 | ¥34 | 4 | ¥15,422 | ¥124,282 (2019) | 0.124 | Yes |
3 | ¥8082 | 0.065 | Yes | |||||
Suzhou | 70% | ¥698 | ¥20 | 4 | ¥8862 | ¥174,129 (2018) | 0.051 | Yes |
3 | ¥3807 | 0.022 | Yes |
TIER-1 Cities | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Beijing | Shanghai | Shenzhen | ||||||||||
VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | ||||
Cases of Pneumococcal Disease 1 | ||||||||||||
Pneumococcal Bacteremia | 1.16 | 1.18 | −0.03 | 1.59 | 1.61 | −0.02 | 0.64 | 0.65 | −0.01 | |||
Pneumococcal Meningitis | 0.32 | 0.33 | −0.01 | 0.43 | 0.44 | −0.01 | 0.19 | 0.20 | 0.00 | |||
Pneumonia (Inpatient) | 268.70 | 283.21 | −14.51 | 348.41 | 361.70 | −13.29 | 147.14 | 153.68 | −6.54 | |||
Pneumonia (Outpatient) | 345.32 | 350.96 | −5.63 | 423.44 | 428.60 | −5.16 | 167.06 | 169.60 | −2.54 | |||
Otitis Media (Mild) | 69.28 | 72.83 | −3.55 | 63.47 | 66.72 | −3.25 | 31.22 | 32.82 | −1.60 | |||
Otitis Media (Mod./Sev.) | 19.82 | 22.13 | −2.31 | 18.16 | 20.28 | −2.12 | 8.93 | 9.97 | −1.04 | |||
Total Cases | 704.61 | 730.64 | −26.03 | 855.50 | 879.35 | −23.85 | 355.19 | 366.92 | −11.73 | |||
Total Deaths | 13.48 | 13.56 | −0.08 | 18.25 | 18.32 | −0.07 | 4.71 | 4.75 | −0.04 | |||
Total QALYs Lost | 146.37 | 147.96 | −1.59 | 195.29 | 196.75 | −1.46 | 73.14 | 73.86 | −0.72 | |||
Costs2 | ||||||||||||
Vaccine Cost | ¥331.06 | ¥0.00 | ¥331.06 | ¥295.11 | ¥0.00 | ¥295.11 | ¥149.19 | ¥0.0 | ¥149.19 | |||
Pneumococcal Bacteremia | ¥1.26 | ¥1.30 | ¥0.05 | ¥1.70 | ¥1.74 | −¥0.04 | ¥0.43 | ¥0.45 | −¥0.02 | |||
Pneumococcal Meningitis | ¥1.15 | ¥1.16 | ¥0.00 | ¥1.55 | ¥1.55 | ¥0.00 | ¥0.37 | ¥0.37 | ¥0.00 | |||
Pneumonia (Inpatient) | ¥3913.23 | ¥3979.43 | −¥66.20 | ¥5221.67 | ¥5282.32 | −¥60.65 | ¥1568.51 | ¥1598.34 | −¥29.83 | |||
Pneumonia (Outpatient) | ¥140.62 | ¥141.93 | −¥1.31 | ¥179.26 | ¥180.46 | −¥1.20 | ¥59.07 | ¥59.66 | −¥0.59 | |||
Otitis Media (Mild) | ¥46.40 | ¥46.75 | −¥0.35 | ¥58.79 | ¥59.10 | −¥0.32 | ¥20.94 | ¥21.10 | −¥0.16 | |||
Otitis Media (Mod./Sev.) | ¥157.75 | ¥164.40 | −¥6.65 | ¥188.84 | ¥194.93 | −¥6.09 | ¥76.32 | ¥79.32 | −¥3.00 | |||
Total Cost | ¥4591.48 | ¥4334.97 | ¥256.51 | ¥5946.91 | ¥5720.11 | ¥226.81 | ¥1874.84 | ¥1759.24 | ¥115.59 | |||
ICER | ¥161,237 | ¥155,625 | ¥161,237 | |||||||||
Other Cities | ||||||||||||
Chengdu | Karamay | Qingdao | Suzhou | |||||||||
VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | VACC. | NO VACC. | INCR. | |
Cases of Pneumococcal Disease 1 | ||||||||||||
Pneumococcal Bacteremia | 1.11 | 1.13 | −0.02 | 0.03 | 0.03 | 0.00 | 0.61 | 0.62 | −0.01 | 0.72 | 0.73 | −0.01 |
Pneumococcal Meningitis | 0.31 | 0.32 | 0.00 | 0.01 | 0.01 | 0.00 | 0.17 | 0.17 | 0.00 | 0.20 | 0.21 | 0.00 |
Pneumonia (Inpatient) | 256.49 | 266.76 | −6.54 | 7.19 | 7.54 | −0.35 | 145.25 | 152.15 | −6.90 | 162.24 | 168.37 | −6.13 |
Pneumonia (Outpatient) | 304.27 | 308.25 | −2.54 | 8.63 | 8.77 | −0.14 | 176.60 | 179.28 | −2.68 | 190.24 | 192.62 | −2.38 |
Otitis Media (Mild) | 49.00 | 51.51 | −1.60 | 1.69 | 1.78 | −0.09 | 32.94 | 34.63 | −1.69 | 29.29 | 30.79 | −1.50 |
Otitis Media (Mod./Sev.) | 14.02 | 15.65 | −1.04 | 0.48 | 0.54 | −0.06 | 9.43 | 10.52 | −1.10 | 8.38 | 9.36 | −0.98 |
Total Cases | 625.20 | 643.61 | −11.73 | 18.03 | 18.67 | −0.64 | 364.99 | 377.37 | −12.38 | 391.07 | 402.08 | −11.01 |
Total Deaths | 11.79 | 11.84 | −0.04 | 0.28 | 0.28 | 0.00 | 6.48 | 6.51 | −0.04 | 7.44 | 7.47 | −0.03 |
Total QALYs Lost | 128.11 | 129.24 | 0.72 | 3.26 | 3.30 | −0.04 | 69.79 | 70.55 | −0.76 | 84.99 | 85.66 | −0.67 |
Costs 2 | ||||||||||||
Vaccine Cost | ¥235.76 | ¥0.00 | ¥235.76 | ¥7.80 | ¥0.00 | ¥7.80 | ¥159.37 | ¥0.00 | ¥159.37 | ¥139.00 | ¥0.00 | ¥139.00 |
Pneumococcal Bacteremia | ¥1.14 | ¥1.17 | −¥0.03 | ¥0.03 | ¥0.03 | ¥0.00 | ¥0.63 | ¥0.65 | −¥0.02 | ¥0.70 | ¥0.72 | −¥0.02 |
Pneumococcal Meningitis | ¥2.61 | ¥2.71 | −¥0.10 | ¥0.07 | ¥0.07 | ¥0.00 | ¥1.42 | ¥1.49 | −¥0.07 | ¥1.76 | ¥1.82 | −¥0.06 |
Pneumonia (Inpatient) | ¥1435.34 | ¥1473.49 | −¥38.14 | ¥36.88 | ¥38.19 | −¥1.32 | ¥808.51 | ¥834.15 | −¥25.65 | ¥895.63 | ¥918.43 | −¥22.80 |
Pneumonia (Outpatient) | ¥82.22 | ¥83.02 | −¥0.80 | ¥2.20 | ¥2.23 | −¥0.03 | ¥47.23 | ¥47.77 | −¥0.54 | ¥51.01 | ¥51.49 | −¥0.48 |
Otitis Media (Mild) | ¥29.69 | ¥30.00 | −¥0.32 | ¥0.85 | ¥0.86 | −¥0.01 | ¥16.96 | ¥17.17 | −¥0.21 | ¥18.94 | ¥19.13 | −¥0.19 |
Otitis Media (Mod./Sev.) | ¥135.57 | ¥140.27 | −¥4.70 | ¥3.97 | ¥4.13 | −¥0.16 | ¥79.35 | ¥82.51 | −¥3.16 | ¥84.39 | ¥87.20 | −¥2.81 |
Total Cost | ¥1922.32 | ¥1730.66 | ¥191.65 | ¥51.79 | ¥45.52 | ¥6.28 | ¥1113.46 | ¥983.74 | ¥129.72 | ¥1191.43 | ¥1078.79 | ¥112.64 |
ICER | ¥170,345 | ¥161,710 | ¥171,496 | ¥167,466 |
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Share and Cite
Li, Y.; Wang, H.; Furnback, W.; Wang, B.C.M.; Zhu, S.; Dong, P. The Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in Seven Chinese Cities. Vaccines 2021, 9, 1368. https://doi.org/10.3390/vaccines9111368
Li Y, Wang H, Furnback W, Wang BCM, Zhu S, Dong P. The Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in Seven Chinese Cities. Vaccines. 2021; 9(11):1368. https://doi.org/10.3390/vaccines9111368
Chicago/Turabian StyleLi, Yan, Huaqing Wang, Wesley Furnback, Bruce C. M. Wang, Shuiqing Zhu, and Peng Dong. 2021. "The Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in Seven Chinese Cities" Vaccines 9, no. 11: 1368. https://doi.org/10.3390/vaccines9111368
APA StyleLi, Y., Wang, H., Furnback, W., Wang, B. C. M., Zhu, S., & Dong, P. (2021). The Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in Seven Chinese Cities. Vaccines, 9(11), 1368. https://doi.org/10.3390/vaccines9111368