Cargando…
Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis
Objective To estimate the cost effectiveness of vaccinating people with high risk conditions against invasive pneumococcal disease using the 13 valent pneumococcal conjugate vaccine. Design Economic evaluation using a cohort model from the perspective of healthcare providers. Setting England. Partic...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2012
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482156/ https://www.ncbi.nlm.nih.gov/pubmed/23103369 http://dx.doi.org/10.1136/bmj.e6879 |
_version_ | 1782247835743289344 |
---|---|
author | Rozenbaum, Mark H van Hoek, Albert Jan Fleming, Douglas Trotter, Caroline L Miller, Elizabeth Edmunds, W John |
author_facet | Rozenbaum, Mark H van Hoek, Albert Jan Fleming, Douglas Trotter, Caroline L Miller, Elizabeth Edmunds, W John |
author_sort | Rozenbaum, Mark H |
collection | PubMed |
description | Objective To estimate the cost effectiveness of vaccinating people with high risk conditions against invasive pneumococcal disease using the 13 valent pneumococcal conjugate vaccine. Design Economic evaluation using a cohort model from the perspective of healthcare providers. Setting England. Participants People aged 2 years and older at increased risk of invasive pneumococcal disease due to chronic kidney disease; splenic dysfunction; HIV infection; a compromised immune system; chronic heart, liver, or respiratory disease; or diabetes. Main outcome measures Costs, gains in life years and quality adjusted life years (QALYs), and incremental cost effectiveness ratios. Results Increasing indirect protection resulting from the vaccination programme of infants using the 13 valent pneumococcal conjugate vaccine means that the burden of disease preventable by targeting high risk groups will diminish in time. Under base case assumptions—that is, no overall impact on non bacteraemic pneumonia in high risk groups and assuming the high risk vaccination programme would be launched two to three years after the infant programme—the incremental cost effectiveness ratio was estimated to be more than £30 000 (€37 216; $48 210) per QALY gained for most risk groups. If, however, the vaccine does not offer protection against non-bacteraemic pneumococcal pneumonia or the vaccine was introduced concomitantly with the infant 13 valent pneumococcal conjugate vaccination programme then vaccinating high risk people would (more) likely be cost effective. Sensitivity analyses showed that the cost effectiveness was particularly sensitive to assumed herd benefits and vaccine efficacy estimates. Conclusion Under base case assumptions it is unlikely that a pneumococcal vaccination programme aimed at risk groups could be considered cost effective. Uncertainty could be substantially reduced by establishing the effectiveness of the 13 valent pneumococcal conjugate vaccine against non-bacteraemic pneumococcal pneumonia, particularly in at risk groups. |
format | Online Article Text |
id | pubmed-3482156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-34821562012-10-31 Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis Rozenbaum, Mark H van Hoek, Albert Jan Fleming, Douglas Trotter, Caroline L Miller, Elizabeth Edmunds, W John BMJ Research Objective To estimate the cost effectiveness of vaccinating people with high risk conditions against invasive pneumococcal disease using the 13 valent pneumococcal conjugate vaccine. Design Economic evaluation using a cohort model from the perspective of healthcare providers. Setting England. Participants People aged 2 years and older at increased risk of invasive pneumococcal disease due to chronic kidney disease; splenic dysfunction; HIV infection; a compromised immune system; chronic heart, liver, or respiratory disease; or diabetes. Main outcome measures Costs, gains in life years and quality adjusted life years (QALYs), and incremental cost effectiveness ratios. Results Increasing indirect protection resulting from the vaccination programme of infants using the 13 valent pneumococcal conjugate vaccine means that the burden of disease preventable by targeting high risk groups will diminish in time. Under base case assumptions—that is, no overall impact on non bacteraemic pneumonia in high risk groups and assuming the high risk vaccination programme would be launched two to three years after the infant programme—the incremental cost effectiveness ratio was estimated to be more than £30 000 (€37 216; $48 210) per QALY gained for most risk groups. If, however, the vaccine does not offer protection against non-bacteraemic pneumococcal pneumonia or the vaccine was introduced concomitantly with the infant 13 valent pneumococcal conjugate vaccination programme then vaccinating high risk people would (more) likely be cost effective. Sensitivity analyses showed that the cost effectiveness was particularly sensitive to assumed herd benefits and vaccine efficacy estimates. Conclusion Under base case assumptions it is unlikely that a pneumococcal vaccination programme aimed at risk groups could be considered cost effective. Uncertainty could be substantially reduced by establishing the effectiveness of the 13 valent pneumococcal conjugate vaccine against non-bacteraemic pneumococcal pneumonia, particularly in at risk groups. BMJ Publishing Group Ltd. 2012-10-26 /pmc/articles/PMC3482156/ /pubmed/23103369 http://dx.doi.org/10.1136/bmj.e6879 Text en © Rozenbaum et al 2012 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. |
spellingShingle | Research Rozenbaum, Mark H van Hoek, Albert Jan Fleming, Douglas Trotter, Caroline L Miller, Elizabeth Edmunds, W John Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis |
title | Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis |
title_full | Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis |
title_fullStr | Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis |
title_full_unstemmed | Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis |
title_short | Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis |
title_sort | vaccination of risk groups in england using the 13 valent pneumococcal conjugate vaccine: economic analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482156/ https://www.ncbi.nlm.nih.gov/pubmed/23103369 http://dx.doi.org/10.1136/bmj.e6879 |
work_keys_str_mv | AT rozenbaummarkh vaccinationofriskgroupsinenglandusingthe13valentpneumococcalconjugatevaccineeconomicanalysis AT vanhoekalbertjan vaccinationofriskgroupsinenglandusingthe13valentpneumococcalconjugatevaccineeconomicanalysis AT flemingdouglas vaccinationofriskgroupsinenglandusingthe13valentpneumococcalconjugatevaccineeconomicanalysis AT trottercarolinel vaccinationofriskgroupsinenglandusingthe13valentpneumococcalconjugatevaccineeconomicanalysis AT millerelizabeth vaccinationofriskgroupsinenglandusingthe13valentpneumococcalconjugatevaccineeconomicanalysis AT edmundswjohn vaccinationofriskgroupsinenglandusingthe13valentpneumococcalconjugatevaccineeconomicanalysis |