Pneumococcal vaccines have costs and the complications in the unvaccinated have higher
DOI:
https://doi.org/10.19230/jonnpr.2127Keywords:
13-valent pneumococcal conjugate vaccine, budget impact, 65-year cohort, pneumococcal disease burden, Spain, differential equations, dynamic modelAbstract
Objective: To analyze the economic impact of vaccination of the 65-year-old cohort with the 13-valent conjugated pneumococcal vaccine (VNC13) in the Autonomous Community of Castilla-La Mancha.
Methods: A dynamic transmission model based on differential equations was adapted to analyze the burden of pneumococcal disease (ND) in the 65+ year old population over 5 years, with 59% being vaccinated annually. An efficacy of VNC13 of 52.5% (CAPITA study), coverage of vaccine serotypes of 60.1% (CAPA study) and incidence of EN in the Community of 258.5 / 100,000 cases year (CMBD 2011- 2015) was applied. . The perspective was that of the SESCAM; costs of hospitalized EN cases according to the CBCA's CMBD (hospitalized pneumonia, € 4,675, invasive pneumonia, € 4,792, meningitis, € 11,9342, primary bacteremia, € 4,792) and cost of extrahospital pneumonia of € 358.
Results: Vaccination with VNC13 would reduce the incidence of EN by 75%, up to 324.7 cases / 100,000 accumulated in 5 years. As a consequence, it is expected to avoid 1,219 cases of EN; 715 hospitalized pneumonias, 437 extra-hospital pneumonias and 67 cases of invasive disease. The expected cost of vaccination in 5 years of 2.3 million euros would be fully compensated by avoiding 3.9 million euros of medical costs of illness, with a cumulative net saving of 1.4 million Euros (discount rate of 3 %). The sensitivity analysis with different scenarios was robust.
Conclusion: The costs of complications from pneumococcal disease are greater than those of a VNC13 pneumococcal vaccination campaign in 65-year-old adults. Death increases in unvaccinated patients.
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