title: The cost-effectiveness of pneumococcal vaccination in healthy adults over 50: An exploration of influential factors for Belgium.
abstract: BACKGROUND
  A recent trial demonstrated the 13 valent conjugate pneumococcal vaccine (PCV13) to be effective against invasive and non-invasive pneumococcal disease in healthy adults. PCV13 might therefore be considered as an alternative to the 23 valent polysaccharide vaccine (PPV23).
  
  
  OBJECTIVE
  To explore the cost-effectiveness of vaccinating healthy adults over 50, with either PCV13 or PPV23 alone, or with a combined strategy using both PCV13 and PPV23.
  
  
  METHODS
  A static multi-cohort model was developed simulating the consequences of pneumococcal vaccination in adults over 50 from a health care payer's perspective, for different scenarios of duration of vaccine protection and serotype evolution.
  
  
  RESULTS
  At currently expected prices, PCV13 vaccination of healthy adults over 50 is unlikely to be cost-effective either compared with no vaccination or in combination with PPV23 versus PPV23 only.
  
  
  CONCLUSIONS
  Further research is needed on vaccine efficacy of the combination strategy and of risk groups, as well as the duration of vaccine protection. Serotype evolutions under the influence of the childhood PCV program should be closely monitored.
authors.affiliation: Centre for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), University of Hasselt, Diepenbeek, Belgium. Electronic address: adriaan.blommaert@uantwerp.be.
authors.forename: Adriaan
authors.initials: A
authors.lastname: Blommaert
authors.affiliation: Centre for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
authors.forename: Joke
authors.initials: J
authors.lastname: Bilcke
authors.affiliation: Centre for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), University of Hasselt, Diepenbeek, Belgium; Department of Mathematics and Computer Science, University of Antwerp, Middelheimlaan 1, B2020 Antwerp, Belgium.
authors.forename: Lander
authors.initials: L
authors.lastname: Willem
authors.affiliation: Department of Clinical Microbiology, Universitair Ziekenhuis Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Verhaegen
authors.affiliation: Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.affiliation: Centre for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; School of Public Health and Community Medicine, University of New South Wales, Australia.
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D003362:Cost-Benefit Analysis; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics / Q000627:therapeutic use*; D014611:Vaccination / Q000191:economics*
chemical_list: C538862:13-valent pneumococcal vaccine; C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines
keywords: Cost-effectiveness analysis; Economic evaluation; Pneumococcal vaccine; Pneumonia