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Impact and cost-effectiveness of different vaccination strategies to reduce the burden of pneumococcal disease among elderly in the Netherlands

Author

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  • Dominic Thorrington
  • Leo van Rossum
  • Mirjam Knol
  • Hester de Melker
  • Hans Rümke
  • Eelko Hak
  • Albert Jan van Hoek

Abstract

Background: Streptococcus pneumoniae causes morbidity and mortality among all ages in The Netherlands. To reduce this burden, infants in The Netherlands receive the 10-valent pneumococcal conjugated vaccine (PCV10), but older persons are not targeted. We assessed the impact and cost-effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23) or 13-valent PCV (PCV13) among all those aged 60, 65 or 70 and/or in combination with replacing PCV10 with PCV13 in the infant vaccination programme. Methods: A static cost-effectiveness model was parameterized including projected trends for invasive pneumococcal disease (IPD) and hospitalised community acquired pneumonia (CAP). The different strategies were evaluated using vaccine list prices and a 10-year time horizon. Incremental cost-effectiveness ratios (ICER) were calculated with the current strategy (infant vaccination program with PCV10) as reference. Results: Compared to the reference, the largest impact on pneumococcal disease burden was projected with a combined use of PCV13 among infants and PPV23 at 60, 65 and 70 years, preventing 1,635 cases of IPD and 914 cases of CAP. The most cost-effective strategy was vaccinating with PPV23 at 70 years only with similar low ICERs at age 60 and 65. The impact of the use of PCV13 among infants depends strongly on the projected herd-immunity effect on serotype 19A. Vaccinating elderly with either PCV13 or PPV23 was dominated by PPV23 in all investigated scenarios, mainly due to the lower price of PPV23. Conclusion: Under the current assumptions, the best value for money is the use of PPV23 for elderly, with a single dose or at five year increment between age 60 to age 70.

Suggested Citation

  • Dominic Thorrington & Leo van Rossum & Mirjam Knol & Hester de Melker & Hans Rümke & Eelko Hak & Albert Jan van Hoek, 2018. "Impact and cost-effectiveness of different vaccination strategies to reduce the burden of pneumococcal disease among elderly in the Netherlands," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-16, February.
    • Handle: RePEc:plo:pone00:0192640
    DOI: 10.1371/journal.pone.0192640
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    References listed on IDEAS

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    1. 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.
    2. Gerhard Falkenhorst & Cornelius Remschmidt & Thomas Harder & Eva Hummers-Pradier & Ole Wichmann & Christian Bogdan, 2017. "Effectiveness of the 23-Valent Pneumococcal Polysaccharide Vaccine (PPV23) against Pneumococcal Disease in the Elderly: Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-18, January.
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    Cited by:

    1. Nancy Vicente-Alcalde & Jose Tuells & Cecilia M. Egoavil & Esther Ruescas-Escolano & Cesare Altavilla & Pablo Caballero, 2020. "Immunization Coverage of Inmates in Spanish Prisons," IJERPH, MDPI, vol. 17(21), pages 1-11, October.
    2. Marina Treskova & Stefan M. Scholz & Alexander Kuhlmann, 2019. "Cost Effectiveness of Elderly Pneumococcal Vaccination in Presence of Higher-Valent Pneumococcal Conjugate Childhood Vaccination: Systematic Literature Review with Focus on Methods and Assumptions," PharmacoEconomics, Springer, vol. 37(9), pages 1093-1127, September.

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