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Economic evaluation of pneumococcal vaccines for adults aged over 50 years in Belgium.
- Source :
-
Human vaccines & immunotherapeutics [Hum Vaccin Immunother] 2018 May 04; Vol. 14 (5), pp. 1218-1229. Date of Electronic Publication: 2018 Feb 22. - Publication Year :
- 2018
-
Abstract
- Streptococcus pneumoniae causes a high disease burden including pneumonia, meningitis and septicemia. Both a polysaccharide vaccine targeting 23 serotypes (PPV23) and a 13-valent conjugate vaccine (PCV13) are indicated for persons aged over 50 years. We developed and parameterized a static multi-cohort model to estimate the incremental cost-effectiveness and budget-impact of these vaccines at different uptake levels. Using three different vaccine efficacy scenarios regarding non-invasive pneumococcal pneumonia and extensive uni- and multivariate sensitivity analyses, we found a strong preference for PPV23 over PCV13 in all age groups at willingness to pay levels below €300 000 per quality adjusted life year (QALY). PPV23 vaccination would cost on average about €83 000, €60 000 and €52 000 per QALY gained in 50-64, 65-74 and 75-84 year olds, whereas for PCV13 this is about €171 000, €201 000 and €338 000, respectively. Strategies combining PPV23 and PCV13 vaccines were most effective but generally less cost-effective. When assuming a combination of increased duration of PCV13 protection, increased disease burden preventable by PCV13 and a 75% reduction of the PCV13 price, PCV13 could become more attractive in <75 year olds, but would remain less attractive than PPV23 from age 75 years onwards. These observations are independent of the assumption that PPV23 has 0% efficacy against non-invasive pneumococcal pneumonia. Pneumococcal vaccination would be most cost-effective in Belgium, when achieving high uptake with PPV23 in 75-84 year olds, as well as by negotiating a lower market-conform PPV23 price to improve uptake and cost-effectiveness.
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Belgium epidemiology
Cost of Illness
Female
Health Services Accessibility economics
Humans
Incidence
Male
Middle Aged
Pneumococcal Infections epidemiology
Pneumococcal Infections microbiology
Pneumococcal Infections prevention & control
Pneumococcal Vaccines therapeutic use
Quality-Adjusted Life Years
Streptococcus pneumoniae immunology
Vaccination methods
Vaccines, Conjugate economics
Vaccines, Conjugate therapeutic use
Cost-Benefit Analysis
Pneumococcal Infections economics
Pneumococcal Vaccines economics
Vaccination economics
Subjects
Details
- Language :
- English
- ISSN :
- 2164-554X
- Volume :
- 14
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Human vaccines & immunotherapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 29420161
- Full Text :
- https://doi.org/10.1080/21645515.2018.1428507