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Cost-effectiveness of pneumococcal vaccination strategies for the elderly in Korea

Author

Listed:
  • 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

Abstract

Background: Although the 13-valent pneumococcal conjugate vaccine (PCV13) showed good efficacy against pneumococcal disease in the the CAPiTA trial, the 23-valent pneumococcal polysaccharide vaccination (PPSV23) program has been ongoing for older adults aged ≥ 65 years in Korea since May of 2013. This study aimed to evaluate the cost-effectiveness of the current vaccination strategy (a single-dose PPSV23 vaccination) compared to a single-dose PCV13 vaccination and sequential PCV13-PPSV23 vaccinations in the elderly population aged ≥ 65 years. Methods: Using a Markov model, the incremental cost-effectiveness ratios (ICERs) of three vaccination strategies were assessed in a societal context. The transition probabilities, utility weights to estimate quality adjusted life year (QALY), and disease treatment costs were either calculated or cited from published data and the Health Insurance Review and Assessment Service. Simulations were performed in hypothetical cohorts of Korean adults aged ≥ 19 years. The vaccine effectiveness of PPSV23 was cited from a Cochrane Review report, while PCV13 effectiveness data were gathered from the CAPiTA trial. Results: Current PPSV23 vaccination strategies were cost-effective (ICER, $25,786 per QALY). However, the administration of PCV13 as a substitute for PPSV23 was shown to be more cost-effective than PPSV23 vaccination (ICER, $797 per QALY). Sequential PCV13-PPSV23 vaccination was also more cost-effective than PPSV23 for elderly people aged ≥ 65 years. In sensitivity analysis assuming significant PPSV23 effectiveness (50%) against non-bacteremic pneumococcal pneumonia, the PCV13 vaccination strategy was superior to the PPSV23 vaccination strategy in terms of cost-effectiveness. Conclusion: The results suggest that PCV13 vaccination is more cost-effective in elderly subjects aged ≥ 65 years compared to the current PPSV23 vaccination strategy. When complete data is obtained in 2018 on the maximal herd effects of childhood PCV13 immunization, the incidence of pneumococcal pneumonia and the cost-effectiveness of vaccination strategies need to be reassessed.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0177342
    DOI: 10.1371/journal.pone.0177342
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    2. 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.
    3. 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.
    4. Albert Jan van Hoek & Elizabeth Miller, 2016. "Cost-Effectiveness of Vaccinating Immunocompetent ≥65 Year Olds with the 13-Valent Pneumococcal Conjugate Vaccine in England," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-14, February.
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