title: Cost-effectiveness of polysaccharide pneumococcal vaccination in people aged 65 and above in Poland.
abstract: BACKGROUND
  Invasive pneumococcal disease is associated with substantial morbidity, mortality and cost implications, which could be reduced by vaccination.
  
  
  OBJECTIVE
  To assess the cost-effectiveness of a 23-valent pneumococcal vaccine in the elderly (65 and older) in Poland.
  
  
  METHODS
  A Markov model with a 1-year cycle length was developed, allowing up to 10 cohorts to enter the model over the lifetime horizon (35 years). In the base case, costs and benefits were assessed using the public health care payer (NFZ) perspective. The analysis included routine vaccination of all elderly and high-risk (HR) elderly versus no vaccination. The analysis assumed that the government would reimburse 50% of the vaccine price. Costs and benefits were discounted 5%, with costs expressed in 2009 Polish Zloty (PLN). Extensive sensitivity analyses were carried out.
  
  
  RESULTS
  PPV23 vaccination targeting all elderly and HR elderly in Poland would avoid 8,935 pneumococcal infections, 2,542 hospitalisations, 671 deaths and 5,886 infections, 1,673 hospitalisations and 441 deaths respectively. The incremental cost per QALY gained would be PLN 3,382 in all elderly and PLN2,148 in HR elderly.
  
  
  CONCLUSIONS
  Vaccinating adults 65 and older regardless of risk status with a 23-valent pneumococcal vaccine, is cost-effective, resulting in clinical and economic benefits including a non-negligible reduction of ambulatory doctor visits, hospitalizations and, deaths in Poland.
authors.affiliation: Infection Prevention Institute; Warsaw, Poland. beatajs@cls.edu.pl
authors.forename: Pawel
authors.initials: P
authors.lastname: Grzesiowski
authors.forename: Raquel
authors.initials: R
authors.lastname: Aguiar-Ibáñez
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kobryń
authors.forename: Laure
authors.initials: L
authors.lastname: Durand
authors.forename: Pierre-Emmanuel
authors.initials: PE
authors.lastname: Puig
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D011008:Pneumococcal Infections / Q000191:economics / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000627:therapeutic use; D011044:Poland; D019057:Quality-Adjusted Life Years
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines
keywords: 23-valent polysaccharide vaccine; Poland; cost-effectiveness; economic burden; elderly; funding; pneumococcal; vacccine