title: Cost-effectiveness of vaccinating the elderly and at-risk adults with the 23-valent pneumococcal polysaccharide vaccine or 13-valent pneumococcal conjugate vaccine in the UK.
abstract: OBJECTIVE
  The introduction of routine childhood vaccination with pneumococcal conjugate vaccines (PCVs) has led to a decrease in the overall incidence of pneumococcal disease in all ages and a change in the serotype distribution of the remaining disease. This study assessed the cost-effectiveness of vaccinating ≥65 years and at risk adults with either the 23-valent pneumococcal polysaccharide vaccine (PPV23) or the 13-valent conjugate vaccine (PCV13) in the UK, accounting for epidemiological changes.
  
  
  METHODS
  A population-based Markov model was used to track one UK-based cohort of individuals assuming PPV23, PCV13 or no vaccination until death.
  
  
  RESULTS
  The ICER was estimated at £8413 when PPV23 was compared to no vaccination. PPV23 dominated PCV13.
  
  
  CONCLUSIONS
  This model suggests that vaccinating with PPV23 is cost-effective when compared to both PCV13 and no vaccination. As PPV23 covers 80-90% in the UK of all serotypes causing invasive pneumococcal diseases, it remains cost-effective despite recent reductions in invasive pneumococcal diseases incidence in adults.
authors.affiliation: Amaris, The Fitzpatrick Building 188 York Way, London N7 9AS, UK.
authors.forename: Yiling
authors.initials: Y
authors.lastname: Jiang
authors.forename: Aline
authors.initials: A
authors.lastname: Gauthier
authors.forename: Sam
authors.initials: S
authors.lastname: Keeping
authors.forename: Stuart
authors.initials: S
authors.lastname: Carroll
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006801:Humans; D015994:Incidence; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D011008:Pneumococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics* / Q000627:therapeutic use*; D011634:Public Health / Q000191:economics*; D018570:Risk Assessment; D012307:Risk Factors; D013222:State Medicine / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines
keywords: cost–effectiveness analysis; epidemiological change; invasive pneumococcal diseases; pneumococcal conjugate vaccine; pneumococcal polysaccharide vaccine