title: Cost of pneumococcal infections and cost-effectiveness analysis of pneumococcal vaccination at risk adults and elderly in Turkey.
abstract: Pneumococcal infections have a substantial burden in Turkey, particularly in the elderly (> 60 years) and at-risk adults (18-59 years). VCR are low at approximately 2%. The first aim of this study was the evaluation of the burden of pneumococcal infections (pneumonia and bacteremia) from a public payer perspective in elderly and at-risk adults. The second aim was the evaluation of cost effectiveness of implementing a large PPV program in these populations. A decision tree model was employed using demographic and epidemiological input obtained from Turkish official sources and international literature. Vaccination was assumed to protect for 5 years with 60% and 50% effectiveness against BPP in elderly and at-risk adults respectively. Vaccination effectiveness of 21% against NBPP was assumed for both populations. Costs input were obtained from a previous study conducted between 2002 and 2008 in a public university hospital in Ankara, Turkey. Univariate sensitivity analyses and Monte-Carlo simulations were performed. The vaccination program was cost effective and cost saving compared to no vaccination, pneumococcal vaccination with 60% coverage led to a mean of 4,695 LYG in the elderly and 2,134 LYG in at-risk adults with 40% coverage. Mean incremental savings reached 45.4 million YTL in the elderly and 21.8 million YTL in at-risk adults. This analysis suggests that pneumococcal vaccination of elderly and at-risk adults is associated with a positive return on investment from a public payer perspective and supports the continued recommendation of pneumococcal vaccines, as well as their full funding in Turkey.
authors: Hacettepe University Department of Public Health, Ankara, Turkey.
authors: Levent
authors: L
authors: Akin
authors: Mehmet
authors: M
authors: Kaya
authors: Serdar
authors: S
authors: Altinel
authors: Laure
authors: L
authors: Durand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D011018:Pneumonia, Pneumococcal / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D014421:Turkey / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines