Alternative strategies for adult pneumococcal polysaccharide vaccination: a cost-effectiveness analysis.
Pneumococcal polysaccharide vaccination (PPV) to prevent invasive pneumococcal disease (IPD) is recommended at age 65 for most persons in the US. We used a Markov model to examine alternative PPV strategies, finding that vaccination at ages 50 and 65 prevented more IPD than present vaccination policies; four decennial vaccinations were most effective. The present vaccination policy costs $3341/QALY gained, vaccinations at 50/65 cost $23,120/QALY and four vaccinations (50/60/70/80) cost $54,451/QALY; results were sensitive to vaccine uptake assumptions, with current policy no longer favored at present vaccination rates. PPV at ages 50/65 may be clinically and, depending on cost-effectiveness criterion used, economically favored over present vaccination recommendations.
Smith
Kenneth J
KJ
Section of Decision Sciences and Clinical Systems Modeling, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States. smithkj2@upmc.edu
Zimmerman
Richard K
RK
Lin
Chyongchiou J
CJ
Nowalk
Mary Patricia
MP
Ko
Feng-Shou
FS
McEllistrem
M Catherine
MC
Roberts
Mark S
MS
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003627:Data Interpretation, Statistical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008070:Lipopolysaccharides / Q000191:economics* / Q000276:immunology*; D008297:Male; D008390:Markov Chains; D008586:Meningitis, Pneumococcal / Q000191:economics / Q000276:immunology / Q000517:prevention & control; D008875:Middle Aged; D015233:Models, Statistical; D011008:Pneumococcal Infections / Q000191:economics* / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000276:immunology*; D012703:Serotyping; D014481:United States
D008070:Lipopolysaccharides; D022242:Pneumococcal Vaccines