IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0197905.html
   My bibliography  Save this article

Estimating the cost-effectiveness of a sequential pneumococcal vaccination program for adults in Germany

Author

Listed:
  • Ulrike Kuchenbecker
  • Daniela Chase
  • Anika Reichert
  • Julia Schiffner-Rohe
  • Mark Atwood

Abstract

Introduction: In Germany, a 23-valent polysaccharide pneumococcal vaccine (PPSV23) is recommended for elderly (60+) and patients 16+ with chronic diseases not associated with immune suppression. For all other patients at risk, sequential immunization with a 13-valent pneumococcal conjugate vaccine (PCV13) first, followed by PPSV23 is recommended. Repeated vaccination with PPSV23 is recommended every 6 years after individual assessment by the physician. This was adopted into the vaccination directive with binding reimbursement and funding. However, additional voluntary services allow statutory health insurances to differentiate from each other. Aim of this study is to estimate the cost-effectiveness of voluntary service scenarios compared to the strategy in place to support informed decision making. Methods: A microsimulation framework with Markov-type process of a population susceptible to pneumococcal disease over a lifetime horizon was developed to compare effectiveness and cost-effectiveness of different vaccination strategies. We simulated 1,000 iterations for seven scenarios. Assumptions were derived from published literature and probabilistic sensitivity analysis was run to show the robustness of the model. Results: Our study indicates that all voluntary service strategies could prevent further clinical cases compared to the existing policy. Depending on the scenario, 48–142 invasive pneumococcal disease (IPD), 24,000–45,000 hospitalized all-cause nonbacteremic pneumonia (NBP), 15,000–45,000 outpatient NBP cases, and 4,000–8,000 deaths could be avoided on average. This refers to potential savings of €115 Mio. - €187 Mio. for medical and non-medical costs. Additional costs per patient for the payer are €2.48 to €7.13 and for the society €2.20 to €6.85. The ICER per LYG ranged from €3,662 to €23,061 (payer) and €3,258 to €29,617 (societal). All but one scenario was cost-effective in ≥60% of the generated 1,000 simulations. Conclusion: Compared to the vaccination strategy in place, the different hypothetical scenarios can be considered cost-effective and suitable as additional voluntary services.

Suggested Citation

  • Ulrike Kuchenbecker & Daniela Chase & Anika Reichert & Julia Schiffner-Rohe & Mark Atwood, 2018. "Estimating the cost-effectiveness of a sequential pneumococcal vaccination program for adults in Germany," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-23, May.
    • Handle: RePEc:plo:pone00:0197905
    DOI: 10.1371/journal.pone.0197905
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197905
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197905&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0197905?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Bernhard Ultsch & Oliver Damm & Philippe Beutels & Joke Bilcke & Bernd Brüggenjürgen & Andreas Gerber-Grote & Wolfgang Greiner & Germaine Hanquet & Raymond Hutubessy & Mark Jit & Mirjam Knol & Rüdiger, 2016. "Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks: A Consensus Framework from a European Vaccine Economics Community," PharmacoEconomics, Springer, vol. 34(3), pages 227-244, March.
    2. Sun-Young Kim & Sue Goldie, 2008. "Cost-Effectiveness Analyses of Vaccination Programmes," PharmacoEconomics, Springer, vol. 26(3), pages 191-215, March.
    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. Qiushi Chen & Turgay Ayer & Jagpreet Chhatwal, 2017. "Sensitivity Analysis in Sequential Decision Models," Medical Decision Making, , vol. 37(2), pages 243-252, February.
    5. 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.
    6. Manuel B. Huber & Peter Reitmeir & Martin Vogelmann & Reiner Leidl, 2016. "EQ-5D-5L in the General German Population: Comparison and Evaluation of Three Yearly Cross-Section Surveys," IJERPH, MDPI, vol. 13(3), pages 1-12, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    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. Hannah Christensen & Hareth Al-Janabi & Pierre Levy & Maarten J. Postma & David E. Bloom & Paolo Landa & Oliver Damm & David M. Salisbury & Javier Diez-Domingo & Adrian K. Towse & Paula K. Lorgelly & , 2020. "Economic evaluation of meningococcal vaccines: considerations for the future," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 297-309, March.
    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.
    4. Manuel B. Huber & Julia Felix & Martin Vogelmann & Reiner Leidl, 2017. "Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L," IJERPH, MDPI, vol. 14(4), pages 1-12, April.
    5. Andrija S Grustam & Nasuh Buyukkaramikli & Ron Koymans & Hubertus J M Vrijhoef & Johan L Severens, 2019. "Value of information analysis in telehealth for chronic heart failure management," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-23, June.
    6. Anthony Newall & Mark Jit & Philippe Beutels, 2012. "Economic Evaluations of Childhood Influenza Vaccination," PharmacoEconomics, Springer, vol. 30(8), pages 647-660, August.
    7. Elahe Khorasani & Majid Davari & Abbas Kebriaeezadeh & Farshad Fatemi & Ali Akbari Sari & Vida Varahrami, 2022. "A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1577-1590, December.
    8. Mario Cesare Nurchis & Alberto Lontano & Domenico Pascucci & Martina Sapienza & Eleonora Marziali & Francesco Castrini & Rosaria Messina & Luca Regazzi & Francesco Andrea Causio & Andrea Di Pilla & Gi, 2022. "COVID-19 Vaccination Campaign among the Health Workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS: A Cost–Benefit Analysis," IJERPH, MDPI, vol. 19(13), pages 1-10, June.
    9. Greg Plosker, 2011. "Rotavirus Vaccine RIX4414 (Rotarix™)," PharmacoEconomics, Springer, vol. 29(11), pages 989-1009, November.
    10. Yuanhui Zhang & Haipeng Wu & Brian T. Denton & James R. Wilson & Jennifer M. Lobo, 2019. "Probabilistic sensitivity analysis on Markov models with uncertain transition probabilities: an application in evaluating treatment decisions for type 2 diabetes," Health Care Management Science, Springer, vol. 22(1), pages 34-52, March.
    11. Zsifkovits, Martin & Zsifkovits, Johannes & Pickl, Stefan W., 2016. "Simulating healthcare quality innovation based on a novel medical treatment: The case of Hepatitis-C in Europe," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 454-459.
    12. Anne-France Viet & Stéphane Krebs & Olivier Rat-Aspert & Laurent Jeanpierre & Catherine Belloc & Pauline Ezanno, 2018. "A modelling framework based on MDP to coordinate farmers' disease control decisions at a regional scale," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-20, June.
    13. Joke Bilcke & Philippe Beutels, 2009. "Reviewing the Cost Effectiveness of Rotavirus Vaccination," PharmacoEconomics, Springer, vol. 27(4), pages 281-297, April.
    14. Jing Voon Chen & Julia L. Higle & Michael Hintlian, 2018. "A systematic approach for examining the impact of calibration uncertainty in disease modeling," Computational Management Science, Springer, vol. 15(3), pages 541-561, October.
    15. Olivier Ethgen & Baudouin Standaert, 2012. "Population–versus Cohort–Based Modelling Approaches," PharmacoEconomics, Springer, vol. 30(3), pages 171-181, March.
    16. van Ackere, Ann & Schulz, Peter J., 2020. "Explaining vaccination decisions: A system dynamics model of the interaction between epidemiological and behavioural factors," Socio-Economic Planning Sciences, Elsevier, vol. 71(C).
    17. 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.
    18. Anna K. Lugnér & Sido D. Mylius & Jacco Wallinga, 2010. "Dynamic versus static models in cost‐effectiveness analyses of anti‐viral drug therapy to mitigate an influenza pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 518-531, May.
    19. Kjell Arne Johansson & Solomon Tessema Memirie & Clint Pecenka & Dean T Jamison & Stéphane Verguet, 2015. "Health Gains and Financial Protection from Pneumococcal Vaccination and Pneumonia Treatment in Ethiopia: Results from an Extended Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-16, December.
    20. 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.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0197905. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.