title: Budget impact analysis of a pneumococcal vaccination programme in the 65-year-old Spanish cohort using a dynamic model.
abstract: BACKGROUND
  This study aimed to assess the costs and clinical benefits of the 13-valent pneumococcal conjugate vaccine (PCV13) administered annually to the 65-year-old cohort in Spain versus the alternative of not vaccinating patients and treating them only when infected.
  
  
  METHODS
  Cases of pneumococcal disease avoided were calculated through a dynamic model based on the work of Anderson and May (1999). Sixty-six percent of the 65-year-old cohort was assumed to have been vaccinated with one PCV13 dose (304,492 subjects). Base-case estimated vaccine effectiveness and serotype coverage were 58% and 60%, respectively. Disease-related costs were calculated based on published data.
  
  
  RESULTS
  Over the 5-year period, a total of 125,906 cases of pneumococcal disease would be avoided. Net savings of €102 million would be obtained. The cost-saving distribution was not homogeneous, starting in the 2nd year and increasing through the 5th. To demonstrate model robustness, an additional scenario analysis was performed using extreme values of model parameters (vaccination programme coverage, vaccine effectiveness, discount rate and disease costs). Under those scenarios, net savings were always achieved.
  
  
  CONCLUSIONS
  Based on the assumptions of the model, the 65-year-cohort pneumococcal vaccination campaign appears to be a cost-saving intervention in the Spanish population under different scenarios.
authors.affiliation: Universidad de la Rioja, Logroño, La Rioja, Spain. rpradasvelasco@gmail.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Pradas
authors.forename: Angel
authors.initials: A
authors.lastname: Gil de Miguel
authors.forename: Alejandro
authors.initials: A
authors.lastname: Álvaro
authors.forename: Ruth
authors.initials: R
authors.lastname: Gil-Prieto
authors.forename: Reyes
authors.initials: R
authors.lastname: Lorente
authors.forename: Cristina
authors.initials: C
authors.lastname: Méndez
authors.forename: Pablo
authors.initials: P
authors.lastname: Guijarro
authors.forename: Fernando
authors.initials: F
authors.lastname: Antoñanzas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011008:Pneumococcal Infections / Q000191:economics* / Q000453:epidemiology*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000191:economics*; D013030:Spain / Q000453:epidemiology
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines