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Cost-effectiveness of PCV13 vaccination in Belgian adults aged 65-84 years at elevated risk of pneumococcal infection

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  • Sophie Marbaix
  • Willy E Peetermans
  • Jan Verhaegen
  • Lieven Annemans
  • Reiko Sato
  • Annick Mignon
  • Mark Atwood
  • Derek Weycker

Abstract

Background: The Belgian Superior Health Council (SHC) recently added a 13-valent pneumococcal conjugate vaccine (PCV13) to its recommendations for adult pneumococcal vaccination. This study addresses the policy question regarding whether a single dose of PCV13 should be reimbursed among Belgian adults aged 65–84 years with chronic comorbidities (“moderate-risk”) or immunosuppression (“high-risk”). Methods: A cohort model was developed to project lifetime risks, consequences, and costs of invasive pneumococcal disease (IPD) and pneumococcal community-acquired pneumonia (CAP). Parameter values were estimated using published literature and available databases, and were reviewed by Belgian experts. PCV13 effectiveness was assumed to be durable during the first 5 years following receipt, and to progressively decline thereafter with 15 years protection. The Belgian National Health Insurance perspective was employed. Results: Use of PCV13 (vs. no vaccine) in moderate/high-risk persons aged 65–84 years (n = 861,467; 58% vaccination coverage) would be expected to prevent 527 cases of IPD, 1,744 cases of pneumococcal CAP and 176 pneumococcal-related deaths, and reduce medical care costs by €20.1 million. Vaccination costs, however, would increase by €36.9 million and thus total overall costs would increase by €16.8 million. Cost per QALY gained was €17,126. In probabilistic sensitivity analyses, use of PCV13 was cost-effective in 97% of 1,000 simulations. Conclusions: Reimbursement of PCV13 in moderate/high-risk Belgian adults aged 65–84 years would be cost-effective from the Belgian healthcare perspective.

Suggested Citation

  • 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.
  • Handle: RePEc:plo:pone00:0199427
    DOI: 10.1371/journal.pone.0199427
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    References listed on IDEAS

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    1. 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.
    2. 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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