Cost-effectiveness of pneumococcal vaccination for elderly in Sweden

Wolff, Ellen; Storsæter, Jann; Örtqvist, Åke; Nauclér, Pontus; Larsson, Sofie; Lepp, Tiia; Roth, Adam

doi:10.1016/j.vaccine.2020.05.072

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…Our findings stand in contrast to the results presented in Wolff et al [2020,34], who investigated the cost-effectiveness of PPSV23 vaccination in elderly in Sweden. Despite the authors' conclusion that a vaccination programme using PPSV23 would reduce the burden of pneumococcus-related disease significantly, the authors estimated the cost per QALY to be EUR 94,0000 for vaccinating 65year-olds.…”

Section: Discussioncontrasting

confidence: 99%

Health economic evaluation of introducing a PPSV23-based vaccination programme to adults aged 65 and above, and an extension to the 60-64 age group in Denmark

Birck¹,

Christensen²,

Pedersen³

et al. 2021

Expert Review of Vaccines

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Background: To estimate the health economic consequences of the recently introduced PPSV23 vaccination programme for persons aged 65+ in Denmark and of a potential extension of the programme to include persons aged 60-64 years. Research design and methods: A Markov model was adapted to the Danish healthcare setting to simulate the epidemiological and economic burden of invasive pneumococcal disease and nonbacteremic pneumococcal pneumonia using information from published sources and Danish databases. Results: We found that the recent introduction of an age-based vaccination programme offering PPSV23 vaccination to the population of persons aged 65+ in Denmark will lead to a societal gain of EUR 72.0 million and prevent 19,707 cases of pneumococcal disease and 1,308 deaths per 1 million persons during the five-year study period.Similarly, we estimate that extending the programme to include persons aged 60-64 will lead to a gain of EUR 14.6 million per 1 million persons and prevent an additional 6,223 cases of pneumococcal disease and 185 deaths. Conclusion:The recent introduction of the age-based vaccination programme offering PPSV23 vaccination to all persons aged 65+ in Denmark is cost-effective. This is also the case if the programme is extended to include persons aged 60-64.

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Section: Discussioncontrasting

confidence: 99%

Health economic evaluation of introducing a PPSV23-based vaccination programme to adults aged 65 and above, and an extension to the 60-64 age group in Denmark

Birck¹,

Christensen²,

Pedersen³

et al. 2021

Expert Review of Vaccines

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“…The model is described in detail elsewhere. 10 A modified schematic from the Swedish analysis using the same model is presented in Figure 1 . The base case analysis measures the impact of vaccinating with PPV23 for a hypothetical 65-year-old and 75-year-old cohort in Norway compared to no vaccination.…”

Section: Methodsmentioning

confidence: 99%

Cost-utility analysis of a universal pneumococcal vaccination programme for older adults in Norway

Nymark

Berild

Lyngstad

et al. 2022

Human Vaccines & Immunotherapeutics

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The aim of this study was to establish whether the universal pneumococcal vaccination for older adults in Norway is likely to be cost-effective from the perspective of the health care provider. A decision tree model developed by the Public Health Agency of Sweden was adapted to the Norwegian setting. Two cohorts, consisting of 65-year-olds and 75-year-olds grouped into vaccinated and unvaccinated, were followed over a 5-year time horizon. In the base case, the 23-valent polysaccharide vaccine (PPV23) was used while the 13-valent pneumococcal conjugate vaccine (PCV13) was included in scenario analyses only. The costs and health benefits (measured in quality adjusted life years (QALY) gained) were compared in the two cohorts between the vaccinated and unvaccinated groups. The impact of indirect effects of the vaccine, such as herd immunity and serotype replacement, were not investigated. The relative importance of change in price was assessed by performing one-way sensitivity analyses. Under base-case assumptions, the programme for the 75-year-old cohort is expected to be dominant (cost-effective) from the health care perspective at the current maximal pharmacy retail price and at 75% vaccination coverage. In comparison, for the 65-year-old cohort the cost per QALY gained is approximately NOK 601,784 (EUR 61,281) under the base-case assumptions. A reduction in the cost of the vaccine to one quarter of its current level also brings the cost per QALY gained within the acceptable ranges in a Norwegian context for both the 65- and 75-year-old cohorts. There is no exact cost-effectiveness threshold in Norway. However, introducing a vaccination programme against pneumococcal disease for 65-year-olds in Norway is likely to fall within the acceptable range while for the 75-year-old cohort the universal programme appears to be dominant (cost-effective).

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“…In this context, recent epidemiological studies have reported an increase in the prevalence of serotypes not covered by the 13-valent vaccine [ 11 , 12 ]. In addition, the use of a single administration of the 23-valent vaccine has been reported to be cost-effective compared to other vaccination strategies in several European countries, [ 13 , 14 , 15 , 16 ]. This vaccination strategy has been used successfully for several years in the United Kingdom, as well as in a number of other European countries [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

The Health Professional’s View on the Inclusion of Age in the Recommendations for Pneumococcal Vaccination: Results of a Cross-Sectional Survey in France

Farge¹,

Wazières

Raude

et al. 2021

Geriatrics

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Elderly people are at high risk for pneumococcal infections. However, older age is not an eligibility factor for pneumococcal vaccination in France. Adults with certain co-morbidities or immunocompromised states are eligible for vaccination, which leaves adults aged ≥65 years without comorbidities at-risk for pneumococcal infections. The objective of the study was to evaluate the acceptability to healthcare professionals (HCPs) of extending pneumococcal vaccination to all individuals ≥65 years. Based on themes identified in semi-structured interviews with 24 HCPs, a representative sample of 500 general practitioners and pharmacists were surveyed about their knowledge, attitudes and beliefs with respect to pneumococcal vaccination for individuals ≥65 years. Current recommendations for pneumococcal vaccination are poorly understood by participants (mean score: 5.8/10). Respondents were generally supportive of inclusion of age in vaccination recommendations (7.5/10), with 58% being very supportive. For 72% of HCPs, this would contribute to improved vaccination coverage. The strategy could be facilitated by associating pneumococcal vaccination with the influenza vaccination campaign (8.3/10). Pharmacists were favourable to participating in pneumococcal vaccination (8.5/10). In conclusion, extension of pneumococcal vaccination to all people aged ≥65 years would be welcomed by HCPs, simplifying identification of patients to be vaccinated and potentially improving vaccination coverage.

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Cost-effectiveness of pneumococcal vaccination for elderly in Sweden

Cited by 11 publications

References 28 publications

Health economic evaluation of introducing a PPSV23-based vaccination programme to adults aged 65 and above, and an extension to the 60-64 age group in Denmark

Health economic evaluation of introducing a PPSV23-based vaccination programme to adults aged 65 and above, and an extension to the 60-64 age group in Denmark

Cost-utility analysis of a universal pneumococcal vaccination programme for older adults in Norway

The Health Professional’s View on the Inclusion of Age in the Recommendations for Pneumococcal Vaccination: Results of a Cross-Sectional Survey in France

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