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Economic Evaluation of Immunisation Programme of 23-Valent Pneumococcal Polysaccharide Vaccine and the Inclusion of 13-Valent Pneumococcal Conjugate Vaccine in the List for Single-Dose Subsidy to the Elderly in Japan

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  • Shu-ling Hoshi
  • Masahide Kondo
  • Ichiro Okubo

Abstract

Background: Currently in Japan, both 23-valent pneumococcal polysaccharide vaccine (PPSV–23) and 13-valent pneumococcal conjugate vaccine (PCV–13) are available for the elderly for the prevention of S. pneumoniae-related diseases. PPSV–23 was approved in 1988, while the extended use of PCV–13 was approved for adults aged 65 and older in June 2014. Despite these two vaccines being available, the recently launched national immunisation programme for the elderly only subsidised PPSV–23. The framework of the current immunisation programme lasts for five years. The elderly population eligible for the subsidised PPSV–23 shot for the 1st year are those aged 65, 70, 75, 80, 85, 90, 95 and ≥100. While from the 2nd year to the 5th year, those who will age 65, 70, 75, 80, 85, 90, 95 and 100 will receive the same subsidised shot. Methods: We performed economic evaluations to (1) evaluate the efficiency of alternative strategies of PPSV–23 single-dose immunisation programme, and (2) investigate the efficiency of PCV–13 inclusion in the list for single-dose pneumococcal vaccine immunisation programme. Three alternative strategies were created in this study, namely: (1) current PPSV–23 strategy, (2) 65 to 80 (as “65–80 PPSV–23 strategy”), and (3) 65 and older (as “≥65 PPSV–23 strategy”). We constructed a Markov model depicting the S. pneumoniae-related disease course pathways. The transition probabilities, utility weights to estimate quality adjusted life year (QALY) and disease treatment costs were either calculated or cited from literature. Cost of per shot of vaccine was ¥8,116 (US$74; US$1 = ¥110) for PPSV–23 and ¥10,776 (US$98) for PCV–13. The model runs for 15 years with one year cycle after immunisation. Discounting was at 3%. Results: Compared to current PPSV–23 strategy, 65–80 PPSV–23 strategy cost less but gained less, while the incremental cost-effectiveness ratios (ICERs) of ≥65 PPSV–23 strategy was ¥5,025,000 (US$45,682) per QALY gained. PCV–13 inclusion into the list for single-dose subsidy has an ICER of ¥377,000 (US$3,427) per QALY gained regardless of the PCV–13 diffusion level. These ICERs were found to be cost-effective since they are lower than the suggested criterion by WHO of three times GDP (¥11,000,000 or US$113,636 per QALY gained), which is the benchmark used in judging the cost-effectiveness of an immunisation programmne. Conclusions: The results suggest that switching current PPSV–23 strategy to ≥65 PPSV–23 strategy or including PCV–13 into the list for single-dose subsidy to the elderly in Japan has value for money.

Suggested Citation

  • Shu-ling Hoshi & Masahide Kondo & Ichiro Okubo, 2015. "Economic Evaluation of Immunisation Programme of 23-Valent Pneumococcal Polysaccharide Vaccine and the Inclusion of 13-Valent Pneumococcal Conjugate Vaccine in the List for Single-Dose Subsidy to the ," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-16, October.
  • Handle: RePEc:plo:pone00:0139140
    DOI: 10.1371/journal.pone.0139140
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    References listed on IDEAS

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    1. Alexander Kuhlmann & Ulrike Theidel & Mathias Pletz & J-Matthias von der Schulenburg, 2012. "Potential cost-effectiveness and benefit-cost ratios of adult pneumococcal vaccination in Germany," Health Economics Review, Springer, vol. 2(1), pages 1-13, December.
    2. Takeru Shiroiwa & Yoon‐Kyoung Sung & Takashi Fukuda & Hui‐Chu Lang & Sang‐Cheol Bae & Kiichiro Tsutani, 2010. "International survey on willingness‐to‐pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 422-437, April.
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    1. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    2. Sophie Marbaix & Willy E Peetermans & Jan Verhaegen & Lieven Annemans & Reiko Sato & Annick Mignon & Mark Atwood & Derek Weycker, 2018. "Cost-effectiveness of PCV13 vaccination in Belgian adults aged 65-84 years at elevated risk of pneumococcal infection," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-16, July.
    3. Jung Yeon Heo & Yu Bin Seo & Won Suk Choi & Jacob Lee & Ji Yun Noh & Hye Won Jeong & Woo Joo Kim & Min Ja Kim & Hee Young Lee & Joon Young Song, 2017. "Cost-effectiveness of pneumococcal vaccination strategies for the elderly in Korea," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-17, May.

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