Adult immunization with 13-valent pneumococcal vaccine in Campania region, South Italy

Abstract

Pneumococcal pneumonia has a high clinical burden in terms of morbidity, mortality and hospitalization rate, with heavy implications for worldwide health systems. In particular, higher incidence and mortality rates of community-acquired pneumonia (CAP) cases, with related costs, are registered among elderly. This study aimed to an economic evaluation about the immunization with PCV13 in the adult population in Campania region, South Italy. For this purpose we performed, considering a period of 5 y, a budget impact analysis (BIA) and a cost-effectiveness analysis which considered 2 scenarios of immunization compared with lack of immunization for 2 targeted cohorts: first, the high risk subjects aged 50–79 y, and second the high risk individuals aged 50–64 y, together with all those aged 65 y. Regarding the first group, the decrease of pneumonia could give savings equal to €29 005 660, while the immunization of the second cohort could allow savings equal to €10 006 017.The economic evaluation of pneumococcal vaccine for adult groups represents an essential instrument to support health policies. This study showed that both hypothesized immunization strategies could produce savings. Obtained results support the use of pneumococcal conjugate vaccine for adults. This strategy could represent a sustainable and savings-producer health policy.

A review of economic evaluations of 13-valent pneumococcal conjugate vaccine (PCV13) in adults and the elderly

“…39 In terms of the type of economic evaluation, 7 publications were cost-utility analyses, presenting cost per Quality Adjusted Life Year (QALY) gained as the primary outcome. 24,[26][27][28][29]31,32 Whereas the studies by Liguori et al 30 and Pradas et al 33 could be classified as cost-effectiveness analyses, calculating the cost per case of pneumococcal disease avoided as the main outcome. …”

“…32 Likewise, in Italy and Spain, although the PPV23 vaccine is recommended for those 65 and high risk 2 y, the coverage rate remains low. 29,30,33 Italy and Spain (partially) have also already introduced PCV13 to their vaccination programs, whereas in the Netherlands, PCV7 was introduced at 2006 and from 2011 PCV10 and PCV13 were available for infants.…”

“…Rozenbaum et al (England) 31 did not include NPP in their (base-case) cost-effectiveness analysis. Liguori et al 30 did not distinguish different forms of pneumococcal disease and included hospitalized CAP (invasive or not) in the analysis.…”

“…Two studies evaluated the implementation of PCV13 vaccination only in those who were in high-risk groups. 30,31 To evaluate the identified studies it is important to also understand the existing pneumococcal vaccination programs into which these new programs are being introduced.…”

“…[24][25][26][27][28] two were conducted for Italy 29,30 and the remaining 3 were performed for England, the Netherlands and Spain respectively. [31][32][33] Of the 5 US publications, 3 were authored by Smith et al 24,26,27 with 2 others by Weycker et al and…”