Cost-effectiveness of adult pneumococcal conjugate vaccination in the Netherlands

نویسندگان

  • Marie-Josée J. Mangen
  • Mark H. Rozenbaum
  • Susanne M. Huijts
  • Cornelis H. van Werkhoven
  • Douwe F. Postma
  • Mark Atwood
  • Anna M.M. van Deursen
  • Arie van der Ende
  • Diederick E. Grobbee
  • Elisabeth A.M. Sanders
  • Reiko Sato
  • Theo J.M. Verheij
  • Conrad E. Vissink
  • Marc J.M. Bonten
  • G. Ardine de Wit
چکیده

The Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) demonstrated the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) in preventing vaccine-type community-acquired pneumonia and vaccine-type invasive pneumococcal disease in elderly subjects. We examined the cost-effectiveness of PCV13 vaccination in the Netherlands. Using a Markov-type model, incremental cost-effectiveness ratios (ICER) of PCV13 vaccination in different age- and risk-groups for pneumococcal disease were evaluated using a societal perspective. Estimates of quality-adjusted life-years (QALYs), costs, vaccine efficacy and epidemiological data were based on the CAPiTA study and other prospective studies. The base-case was PCV13 vaccination of adults aged 65-74 years compared to no vaccination, assuming no net indirect effects in base-case due to paediatric 10-valent pneumococcal conjugate vaccine use. Analyses for age- and risk-group specific vaccination strategies and for different levels of hypothetical herd effects from a paediatric PCV programme were also conducted. The ICER for base-case was €8650 per QALY (95% CI 5750-17,100). Vaccination of high-risk individuals aged 65-74 years was cost-saving and extension to medium-risk individuals aged 65-74 years yielded an ICER of €2900. Further extension to include medium- and high-risk individuals aged ≥18 years yielded an ICER of €3100.PCV13 vaccination is highly cost-effective in the Netherlands. The transferability of our results to other countries depends upon vaccination strategies already implemented in those countries.

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عنوان ژورنال:

دوره 46  شماره 

صفحات  -

تاریخ انتشار 2015