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The European respiratory journal
Nov, 2015;46 (5): 1407-16.

Cost-effectiveness of adult pneumococcal conjugate vaccination in the Netherlands.

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
Author Information
  1. Marie-Josée J Mangen: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands These authors contributed equally m.j.j.mangen@umcutrecht.nl.
  2. Mark H Rozenbaum: Pfizer, Capelle a/d IJssel, The Netherlands Unit of Pharmacoepidemiology and PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands These authors contributed equally.
  3. Susanne M Huijts: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Department Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands These authors contributed equally.
  4. Cornelis H van Werkhoven: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
  5. Douwe F Postma: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
  6. Mark Atwood: Policy Analysis Inc., Brookline, MA, USA These authors are listed alphabetically.
  7. Anna M M van Deursen: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Spaarne Gasthuis Academie, Spaarne Gasthuis, Hoofddorp, The Netherlands Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands These authors are listed alphabetically.
  8. Arie van der Ende: Department of Medical Microbiology, Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands These authors are listed alphabetically.
  9. Diederick E Grobbee: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Julius Clinical, Academic Contract Research Organization, Zeist, The Netherlands These authors are listed alphabetically.
  10. Elisabeth A M Sanders: Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands These authors are listed alphabetically.
  11. Reiko Sato: Pfizer Inc., Collegeville, PA, USA These authors are listed alphabetically.
  12. Theo J M Verheij: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands These authors are listed alphabetically.
  13. Conrad E Vissink: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands These authors are listed alphabetically.
  14. Marc J M Bonten: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands Joint senior authors.
  15. G Ardine de Wit: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Joint senior authors.
PMID: 26160871 DOI: 10.1183/13993003.00325-2015

Abstract

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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MeSH Term

Adolescent
Adult
Aged
Aged, 80 and over
Cost-Benefit Analysis
Female
Humans
Male
Markov Chains
Middle Aged
Netherlands
Pneumococcal Infections
Pneumococcal Vaccines
Prospective Studies
Quality-Adjusted Life Years
Vaccination
Young Adult

Chemicals

13-valent pneumococcal vaccine
Pneumococcal Vaccines
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 18

Word Cloud

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