ECONOMIC EVALUATION OF PNEUMOCOCCAL RISK GROUP VACCINATIONS IN FINLAND
The cost-effectiveness studies of adult pneumococcal vaccinations have shown discordant results. We evaluated the cost-effectiveness of pneumococcal vaccinations for high-risk groups in 18–84-year-olds under the PCV13 childhood vaccination programme.
A multi-cohort model with 15 year time-horizon was applied to estimate the cost-effectiveness of PCV13 and PPV23 vaccinations for various age and risk groups. Risk groups (diabetes, asthma or chronic obstructive pulmonary disease (COPD), renal failure or chronic heart failure) were defined using the Register for Special Reimbursements of medical expenses. The pneumococcal disease incidence in the risk groups were estimated by linking individual’s events within and between individual-level national registries.
The disease incidence was highest among the renal failure risk group and both PCV13 and PPV23 vaccinations were cost-saving in 18–74-year-olds. In ≥65-year-olds PPV23 vaccinations were more cost-effective than PCV13 vaccinations. In all risk groups both vaccinations were most cost-effective in 65–74-year-olds. The results were sensitive to the changes in effectiveness and price of both vaccines and assumed mortality impact of vaccinations and life expectancy estimates.
Life expectancy affects significantly the cost-effectiveness results among the elderly. When evaluating the cost-effectiveness of pneumococcal risk group vaccinations it’s important to consider the high all-cause mortality among the elderly at-risk population.