title: [A Dynamic Model to Estimate the Budget Impact of a Pneumococcal Vaccination Program in a 65 Year-old immunocompetent Spanish Cohort with 13-Valent Pneumococcal Conjugate Vaccine].
abstract: OBJECTIVE
  To estimate the 5-year clinical and economic impact of a pneumococcal vaccination program on immunocompetent population aged 65-year-old in Spain.
  
  
  METHODS
  A 5 year dynamic model based on differential equations was built for the conceptualization of the burden of pneumococcal disease (PD) on a 65 year-old cohort. A 36.5% of the cohort was vaccinated with an expected efficacy rate of 52.5% as observed in the CAPITA study. The serotype vaccination coverage used was 63.4% (CAPA study), the incidence of pneumococcal disease was 162.2 per 100,000 cases per year (CMBD 2010-2013) and a rate of vaccinated subjects previously from the start of the model of 0.99%. The study used the perspective of The National Health System, and included the costs associated to PD and the conjugate vaccine laboratory selling price.
  
  
  RESULTS
  In a 5 years-period, the vaccination with 13-valent pneumococcal conjugate vaccine is expected to avoid 10,360 cases of pneumococcal disease (7,411 in-patient pneumonias) and 699 deaths (14,736 Life Years Gained) in the 65 year old cohort. Vaccination costs of 36.5 million euros would be completely offset by medical cost reduction of 41.5 million euros, yielding to a net saving of 3.8 million constant euros (4.9 million undiscounted).
  
  
  CONCLUSIONS
  PCV13 vaccination targeting the cohort of 65 year-old immunocompetent Spanish adults is expected to result in net savings for the National Health System, while decreasing disease burden and averting a substantial number of related deaths.
authors.affiliation: Departamento de Economía y Empresa, Universidad de La Rioja, Logroño.
authors.forename: Reyes
authors.initials: R
authors.lastname: Lorente Antoñanzas
authors.affiliation: Departamento de Matemáticas y Computación. Universidad de La Rioja, Logroño.
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Varona Malumbres
authors.affiliation: Departamento de Economía y Empresa, Universidad de La Rioja, Logroño.
authors.forename: Fernando
authors.initials: F
authors.lastname: Antoñanzas Villar
authors.affiliation: Departamento de Investigación de Resultados en Salud y Farmacoeconomía. Pfizer SLU. Alcobendas. Madrid.
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas Gutiérrez
mesh_terms: D000368:Aged; D002017:Budgets; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007121:Immunocompetence; D015994:Incidence; D008297:Male; D008962:Models, Theoretical; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000191:economics; D013030:Spain / Q000453:epidemiology; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000191:economics
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Adults; Burden of illness; Conjugate vaccine; Health expenditure; Pneumococcal vaccines; Spain