Cost effectiveness of pneumococcal vaccination for infants and children with the conjugate vaccine PnC-7 in Germany.
BACKGROUND
The introduction of the conjugate vaccine PnC-7 implies that a pneumococcal vaccine is available, for the first time, which also gives children under the age of 2 years reliable protection against invasive pneumococcal infections and offers some protection against non-invasive pneumococcal infections. OBJECTIVE AND PERSPECTIVE: In the context of a multiple-period Markov model, a cost-effectiveness analysis of a recommendation for general pneumococcal vaccination in Germany for infants and children under the age of 2 years was performed from the healthcare payer, public authority and societal perspectives.


METHODS
Various published data on age-specific incidence rates, mortality rates, efficacy of the conjugate vaccine PnC-7 and treatment costs of pneumococcal infections were incorporated into a Markov model to quantify the consequences of vaccinating versus not vaccinating.


RESULTS
From a German healthcare payers' perspective, general vaccination with the conjugate vaccine would redeem 51.1% of the vaccination costs due to avoidable treatment costs, whereas, from a broader point of view, the benefits, expressed in monetary terms, would exceed the cost of vaccination. The conjugate vaccine would require an investment of euro72 866 per life-year saved (discounted, healthcare payers' viewpoint). Besides this benchmark, there are further outcome measures which cannot be ignored by those deciding on a general vaccination recommendation: 450 000 preventable episodes of illness and 134 cases of sequelae which can be prevented.


CONCLUSIONS
The vaccination with the conjugate vaccine PnC-7 is cost saving from a broader perspective and the results should not be ignored by policy makers in regard to a general vaccination recommendation.
Claes
Christa
C
Institute for Insurance Economics, University of Hannover, Koenigsworther Platz 1, D-30167 Hannover, Germany. cc@ivbl.uni-hannover.de
Graf von der Schulenburg
Johann-Matthias
JM
D000367:Age Factors; D003362:Cost-Benefit Analysis; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008390:Markov Chains; D011008:Pneumococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics*; D011336:Probability; D018074:Vaccines, Conjugate / Q000191:economics
D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate