Is routine immunization of elderly with the 13-valent pneumococcal conjugate vaccine likely to be considered as cost-effective?

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Abstract

OBJECTIVES: To estimate the cost-effectiveness in relation to the efficacy of PCV-13 among elderly (both the total population and those at increased risk) aged 65 years and older for the The Netherlands, for various levels of efficacy assumed. METHODS: Our previously published cost-effectiveness model was updated to include, age-specific epidemiological data and health care utilization and costs for a hypothetical cohort of elderly aged over 65 years of the population of the The Netherlands. This cohort was followed twice- once as unvaccinated and once as a vaccinated cohort- over a time period of 5 years. Outcome measures included costs, life-years (LYs), qualityadjusted life-years (QALYs) and cost-effectiveness ratios (CERs). All analyses were performed from a societal perspective. RESULTS: Vaccination remained well below the €80,000 per LY except if the vaccine was only assumed to be protective against bacteraemic pneumonia with a relatively low effectiveness (40%) in combination with a high vaccine price (€65) and indirect effects of serotype replacement would largely offset the direct effect of vaccination. For various assumptions, introduction PCV-13 (assuming a 60% efficacy against invasive and non invasive disease due to vaccine serotypes, and a cost of €50 per vaccinated person) the incremental cost-effectiveness ratio varies over from cost-saving to €50,676 per LY. More probable scenarios generated cost-effectiveness ratios which would be labeled as cost-effective. CONCLUSIONS: In the The Netherlands, vaccination with PCV-13 is likely to be considered cost-effective both for the total and for the high-risk population over 65 years of age from a societal perspective over a five-year time horizon. The main limitation of this study was the uncertainty regarding the share of pneumococcal related pneumonia.
Original languageEnglish
Pages (from-to)378
Number of pages1
JournalValue in Health
Volume13
Issue number7
Publication statusPublished - 1-Nov-2010

Keywords

  • vaccine
  • human
  • aged
  • immunization
  • cost effectiveness analysis
  • vaccination
  • Netherlands
  • pneumonia
  • population
  • model
  • epidemiological data
  • health care utilization
  • serotype
  • cost control
  • risk
  • high risk population

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