Cost-Effectiveness of 23-Valent Pneumococcal Vaccine in Catalonia (Spain)

OBJECTIVE: In this study, cost-effectiveness of the 23-valent pneumococcal vaccination was assessed in Catalonia (Spain). METHODS: Cost-effectiveness was measured in terms of cost per life year gained (LYG), comparing net program costs and effectiveness. The net program cost was calculated from vaccinating cost, less reduced health care costs from pneumococcal pneumonia achieved with the intervention. Vaccination costs were calculated taking into account a cost of 11.51 per vaccine. Costs and benefits were estimated for the period 1996-2000 using a 5% discount rate. RESULTS: A cost-effectiveness ratio of 9,023 per LYG was obtained for the strategy consisting in the universal vaccination of individuals aged >5 years. The cost-effectiveness ratio was 113,177 per LYG in individual aged 5-24 years, 19,482 per LYG in those aged 25-44 years, 7,123 per LYG in those aged 45-64 years and -4,442 per LYG in those aged >64 years. In the age-group of >64 years, health care costs reduced were higher than vaccination costs, with a savings/costs ratio of 1.58. Results of cost-effectiveness analysis were sensitive to the vaccine price, vaccine efficacy, percentage of pneumonias caused by S. pneumoniae and discount rate, being less sensitive to the hospitalization rate in patients with a community-acquired pneumonia and the vaccination coverage CONCLUSION: Results obtained in this study shows that pneumococcal vaccination should be a priority preventive intervention in individuals aged >64 and 45-64 years