Marbaix S, Peetermans WE, Verhaegen J, Annemans L, Sato R, Mignon A, Atwood M, Weycker D. Cost-effectiveness of PCV13 vaccination in Belgian adults aged 65-84 years at elevated risk of pneumococcal infection.
PLoS One 2018;
13:e0199427. [PMID:
29979689 PMCID:
PMC6034794 DOI:
10.1371/journal.pone.0199427]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 06/07/2018] [Indexed: 12/25/2022] Open
Abstract
Background
The Belgian Superior Health Council (SHC) recently added a 13-valent pneumococcal conjugate vaccine (PCV13) to its recommendations for adult pneumococcal vaccination. This study addresses the policy question regarding whether a single dose of PCV13 should be reimbursed among Belgian adults aged 65–84 years with chronic comorbidities (“moderate-risk”) or immunosuppression (“high-risk”).
Methods
A cohort model was developed to project lifetime risks, consequences, and costs of invasive pneumococcal disease (IPD) and pneumococcal community-acquired pneumonia (CAP). Parameter values were estimated using published literature and available databases, and were reviewed by Belgian experts. PCV13 effectiveness was assumed to be durable during the first 5 years following receipt, and to progressively decline thereafter with 15 years protection. The Belgian National Health Insurance perspective was employed.
Results
Use of PCV13 (vs. no vaccine) in moderate/high-risk persons aged 65–84 years (n = 861,467; 58% vaccination coverage) would be expected to prevent 527 cases of IPD, 1,744 cases of pneumococcal CAP and 176 pneumococcal-related deaths, and reduce medical care costs by €20.1 million. Vaccination costs, however, would increase by €36.9 million and thus total overall costs would increase by €16.8 million. Cost per QALY gained was €17,126. In probabilistic sensitivity analyses, use of PCV13 was cost-effective in 97% of 1,000 simulations.
Conclusions
Reimbursement of PCV13 in moderate/high-risk Belgian adults aged 65–84 years would be cost-effective from the Belgian healthcare perspective.
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