IJE Advance Access published online on March 11, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyh341
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
* To whom correspondence should be addressed. Background Polysaccharide pneumococcal vaccination for older adults is being introduced in developed country settings. Evidence of protection by this vaccine against pneumococcal pneumonia, or confirmation that illness and death from bacteraemia are prevented, is currently limited. Decisions are often made based on partial information. We examined the policy implications by exploring the potential economic benefit to society and the health sector of pneumococcal vaccination in older adults. Methods A model to estimate the potential cost savings and cost-effectiveness of a polysaccharide pneumococcal vaccine programme was based on costs collected from patients, the literature, and routine health-services data. The effect of a pneumococcal vaccine (compared with no vaccination) was examined in a hypothetical cohort aged over 64 years. The duration of protection was assumed to be 10 years, with or without a booster at 5 years. Results If it were effective against morbidity from pneumococcal pneumonia, the main burden from pneumococcal disease, the vaccine could be cost-neutral to society or the health sector at low efficacy (28 and 37.5%, respectively, without boosting and with 70% coverage). If it were effective against morbidity from bacteraemia only, the vaccine's efficacy would need to be 75 and 89%, respectively. If protection against both morbidity and mortality from pneumococcal bacteraemia was 50%, the net cost to society would be £2500 per year of life saved (£3365 from the health-sector perspective). Results were sensitive to incidence, casefatality rates, and costs of illness. Conclusions A vaccine with moderate efficacy against bacteraemic illness and death would be cost-effective. If it also protected against pneumonia, it would be cost-effective even if its efficacy were low.
Original paper
An economic analysis of a pneumococcal vaccine programme in people aged over 64 years in a developed country setting
2 MRC Laboratories, PO Box 273, The Gambia
Punam Mangtani, E-mail: Punam.Mangtani{at}lshtm.ac.uk
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in Int. J. Epidemiol.:
- Commentary: Pneumococcal immunization may not be cost-effective in the elderly in developed countries
- Norman Waugh
Int. J. Epidemiol. 2005 10.1093/ije/dyi009.[Abstract]
This article has been cited by other articles:
|
|
 |
|
  J H S You, W C W Wong, M Ip, N L S Lee, and S C Ho Cost-effectiveness analysis of influenza and pneumococcal vaccination for Hong Kong elderly in long-term care facilities J Epidemiol Community Health, November 1, 2009; 63(11): 906 - 911. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Goldhaber-Fiebert, N. K. Stout, J. A. Salomon, K. M. Kuntz, and S. J. Goldie Cost-Effectiveness of Cervical Cancer Screening With Human Papillomavirus DNA Testing and HPV-16,18 Vaccination J Natl Cancer Inst, March 5, 2008; 100(5): 308 - 320. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Waugh Commentary: Pneumococcal immunization may not be cost-effective in the elderly in developed countries Int. J. Epidemiol., June 1, 2005; 34(3): 575 - 576. [Full Text] [PDF]
|
|