The cost-effectiveness of starting 23-valent pneumococcal polysaccharide vaccine and influenza vaccination at 50 vs. 65 years: A comparative modelling study

被引:3
作者
Ding, Hanyue [1 ]
Huang, Junjie [1 ]
Ngai, Chun Ho [1 ]
Sun, Qingjie [1 ]
Kwok, Kin-On [1 ]
Wang, Harry H. X. [2 ]
Chong, Marc [1 ]
Wong, Martin C. S. [1 ]
机构
[1] Chinese Univ Hong Kong, Fac Med, JC Sch Publ Hlth & Primary Care, Hong Kong, Peoples R China
[2] Sun Yat Sen Univ, Sch Publ Hlth, Guangzhou, Peoples R China
关键词
Pneumococcal infection; Vaccine; Quality-adjusted life-years; Cost-effective analysis; CONJUGATE VACCINE; ADULTS; DISEASE; PPV23;
D O I
10.1016/j.vaccine.2022.01.033
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objectives: Pneumococcal infection is a leading cause of morbidity and mortality. We aimed to evaluate the cost-effectiveness of 23-valent polysaccharide vaccine (PPV23) together with influenza vaccination or pneumococcal vaccination alone in adults starting from 50 years vs. 65 years in Hong Kong. Methods: A hypothetical population of 100,000 older adults was included in a Markov model with age ranging from 50 to 85 years to calculate the cost and quality-adjusted life-years (QALYs) gained for vaccination strategies, including: (1) annual influenza vaccine and PPV23 at 50 and 65 years; (2) annual influenza vaccine and PPV23 at 65 years (similar with the current vaccination programme); (3) PPV23 at 50 and 65 years; (4) PPV23 at 65 years; and (5) no vaccination. We evaluated the incremental costeffectiveness ratio (ICER) and used Monte Carlo simulation for probabilistic sensitivity analysis. The cost-effectiveness threshold was extracted from previous literature. Results: In comparison with no vaccination, all strategies were cost-effective with ICERs less than the threshold (US$24,302 per QALY gained). When compared with no vaccination, strategies 1-4 saved US $ 49.5, US$ 94.9, US$ 584.3, and US$ 1114.2 to gain one QALY respectively. In comparison with strategy 2, strategy 1 spent US$ 195.3 to gain one QALY, whilst strategies 3 and 4 showed less effectiveness with increased costs. Conclusions: All vaccination strategies were cost-effective, among which the strategy of PPV23 at 50/65 years with annual influenza vaccine was cost-effective even in comparison with current vaccination programme. These findings could help inform the design and implementation of vaccination strategies. (c) 2022 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1282 / 1288
页数:7
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