IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0149540.html
   My bibliography  Save this article

Cost-Effectiveness of Vaccinating Immunocompetent ≥65 Year Olds with the 13-Valent Pneumococcal Conjugate Vaccine in England

Author

Listed:
  • Albert Jan van Hoek
  • Elizabeth Miller

Abstract

Background: Recently a large clinical trial showed that the use of 13-valent pneumococcal conjugate vaccine (PCV13) among immunocompetent individuals aged 65 years and over was safe and efficacious. The aim of this study was to assess the cost-effectiveness of vaccinating immunocompetent 65 year olds with PCV13 vaccine in England. England is a country with universal childhood pneumococcal conjugate vaccination programme in place (7-valent (PCV7) since 2006 and PCV13 since 2010), as well as a 23-valent pneumococcal polysaccharide (PPV23) vaccination programme targeting clinical risk-groups and those ≥65 years. Method: A static cohort cost-effectiveness model was developed to follow a cohort of 65 year olds until death, which will be vaccinated in the autumn of 2016 with PCV13. Sensitivity analysis was performed to test the robustness of the results. Results: The childhood vaccination programme with PCV7 has induced herd protection among older unvaccinated age groups, with a resultant low residual disease burden caused by PCV7 vaccine types. We show similar herd protection effects for the 6 additional serotypes included in PCV13, and project a new low post-introduction equilibrium of vaccine-type disease in 2018/19. Applying these incidence projections for both invasive disease and community-acquired pneumonia (CAP), and using recent measures of vaccine efficacy against these endpoints for ≥65 year olds, we estimate that vaccination of a cohort of immunocompetent 65 year olds with PCV13 would directly prevent 26 cases of IPD, 69 cases of CAP and 15 deaths. The associated cost-effectiveness ratio is £257,771 per QALY gained (using list price of £49.10 per dose and £7.51 administration costs) and is therefore considered not cost-effective. To obtain a cost-effective programme the price per dose would need to be negative. The results were sensitive to disease incidence, waning vaccine protection and case fatality rate; despite this, the overall conclusion was robust. Conclusions: Vaccinating immunocompetent individuals aged ≥65 years with PCV13 is efficacious. However the absolute incidence of vaccine-type disease will likely become very low due to wider benefits of the childhood PCV13 vaccination programme, such that a specific PCV13 vaccination programme targeting the immunocompetent elderly would not be cost-effective.

Suggested Citation

  • 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.
  • Handle: RePEc:plo:pone00:0149540
    DOI: 10.1371/journal.pone.0149540
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149540
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0149540&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0149540?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. Stavros Petrou & Christine Hockley, 2005. "An investigation into the empirical validity of the EQ‐5D and SF‐6D based on hypothetical preferences in a general population," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1169-1189, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    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. 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.
    3. 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.
    4. 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.
    5. 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.

    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. Kontodimopoulos, Nick & Niakas, Dimitris, 2008. "An estimate of lifelong costs and QALYs in renal replacement therapy based on patients' life expectancy," Health Policy, Elsevier, vol. 86(1), pages 85-96, April.
    2. Garry Barton & Tracey Sach & Michael Doherty & Anthony Avery & Claire Jenkinson & Kenneth Muir, 2008. "An assessment of the discriminative ability of the EQ-5D index , SF-6D, and EQ VAS, using sociodemographic factors and clinical conditions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(3), pages 237-249, August.
    3. Shitong Xie & Jing Wu & Gang Chen, 2024. "Comparative performance and mapping algorithms between EQ-5D-5L and SF-6Dv2 among the Chinese general population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 7-19, February.
    4. Bruno Casal & Eva Rodríguez-Míguez & Berta Rivera, 2020. "Measuring intangible cost-of-morbidity due to substance dependence: implications of using alternative preference-based instruments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(7), pages 1039-1048, September.
    5. Mukuria, Clara & Brazier, John, 2013. "Valuing the EQ-5D and the SF-6D health states using subjective well-being: A secondary analysis of patient data," Social Science & Medicine, Elsevier, vol. 77(C), pages 97-105.
    6. Mengjun Wu & John Brazier & Benjamin Kearns & Clare Relton & Christine Smith & Cindy Cooper, 2015. "Examining the impact of 11 long-standing health conditions on health-related quality of life using the EQ-5D in a general population sample," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 141-151, March.
    7. Michela Tinelli & Mandy Ryan & Christine Bond & Anthony Scott, 2013. "Valuing Benefits to Inform a Clinical Trial in Pharmacy," PharmacoEconomics, Springer, vol. 31(2), pages 163-171, February.
    8. Nick Kontodimopoulos & Michalis Argiriou & Nikolaos Theakos & Dimitris Niakas, 2011. "The impact of disease severity on EQ-5D and SF-6D utility discrepancies in chronic heart failure," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(4), pages 383-391, August.
    9. Clare C. Brown & J. Mick Tilford & Nalin Payakachat & D. Keith Williams & Karen A. Kuhlthau & Jeffrey M. Pyne & Renske J. Hoefman & Werner B. F. Brouwer, 2019. "Measuring Health Spillover Effects in Caregivers of Children with Autism Spectrum Disorder: A Comparison of the EQ-5D-3L and SF-6D," PharmacoEconomics, Springer, vol. 37(4), pages 609-620, April.
    10. Garry R. Barton & Tracey H. Sach & Anthony J. Avery & Claire Jenkinson & Michael Doherty & David K. Whynes & Kenneth R. Muir, 2008. "A comparison of the performance of the EQ‐5D and SF‐6D for individuals aged ≥ 45 years," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 815-832, July.
    11. John N. Yfantopoulos & Athanasios E. Chantzaras, 2017. "Validation and comparison of the psychometric properties of the EQ-5D-3L and EQ-5D-5L instruments in Greece," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(4), pages 519-531, May.
    12. Henry Ireys & Jonathan Brown & Ellen Bouchery & Liz Babalola & Michael Barna & Crystal Blyler & Dan Friend & Christine Fulton & Matt Kehn & Tricia Higgins & Jasmine Little & Jennifer Lyons & Jessica N, "undated". "Evaluating the HCIA – Behavioral Health/Substance Abuse Awards: Second Annual Report," Mathematica Policy Research Reports f421a5fb2edd46b79046bc7f9, Mathematica Policy Research.
    13. Carmen Selva-Sevilla & Paula Ferrara & Manuel Gerónimo-Pardo, 2020. "Interchangeability of the EQ-5D and the SF-6D, and comparison of their psychometric properties in a spinal postoperative Spanish population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 649-662, June.
    14. Maheswaran, Hendramoorthy & Kupek, Emil & Petrou, Stavros, 2015. "Self-reported health and socio-economic inequalities in England, 1996–2009: Repeated national cross-sectional study," Social Science & Medicine, Elsevier, vol. 136, pages 135-146.
    15. Richard Huan Xu & Dong Dong & Nan Luo & Eliza Lai-Yi Wong & Yushan Wu & Siyue Yu & Renchi Yang & Junshuai Liu & Huiqin Yuan & Shuyang Zhang, 2021. "Evaluating the psychometric properties of the EQ-5D-5L and SF-6D among patients with haemophilia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 547-557, June.
    16. Fan Yang & Titus Lau & Evan Lee & A. Vathsala & Kee Chia & Nan Luo, 2015. "Comparison of the preference-based EQ-5D-5L and SF-6D in patients with end-stage renal disease (ESRD)," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(9), pages 1019-1026, December.
    17. Silvia Garrido & Ildefonso Méndez & José-María Abellán, 2013. "Analysing the Simultaneous Relationship Between Life Satisfaction and Health-Related Quality of Life," Journal of Happiness Studies, Springer, vol. 14(6), pages 1813-1838, December.
    18. Nick Kontodimopoulos & Evelina Pappa & Zinovia Chadjiapostolou & Eleni Arvanitaki & Angelos Papadopoulos & Dimitris Niakas, 2012. "Comparing the sensitivity of EQ-5D, SF-6D and 15D utilities to the specific effect of diabetic complications," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 111-120, February.

    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:pone00:0149540. 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.