title: Cost effectiveness of vaccination against pneumococcal pneumonia: an update.
abstract: We updated a 1978 cost-effectiveness analysis of vaccination against pneumococcal pneumonia in light of the introduction in 1983 of a 23-valent vaccine, recent medical literature, and different relative prices of medical services. Although other base-case assumptions have remained reasonable, the low estimates of 10% of pneumonia as pneumococcal and a 3-year duration of immunity now appear more likely. Vaccination of a person age 65 or older could gain a year of healthy life for about $6000 in 1983 dollars. Medicare has covered pneumococcal vaccination since 1981. With the revised assumptions, net Medicare expenditures ranged from about $5.50 to $10.50 per vaccination, or from $4400 to $8300 per year of healthy life gained. Vaccination of an elderly person would almost break even, if duration of immunity were 8 years and would be cost saving if the vaccine were administered under a public program. Current levels of vaccination appear too low considering the potential health benefits and cost-effectiveness.
authors.forename: J E
authors.initials: JE
authors.lastname: Sisk
authors.forename: R K
authors.initials: RK
authors.lastname: Riegelman
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis; D001428:Bacterial Vaccines / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D006801:Humans; D006278:Medicare / Q000191:economics; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D018805:Sepsis / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000276:immunology; D013997:Time Factors; D014481:United States; D014611:Vaccination / Q000191:economics*
chemical_list: D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D022242:Pneumococcal Vaccines