Pneumococcal pneumonia in the UK—how herd immunity affects the cost-effectiveness of 7-valent pneumococcal conjugate vaccine (PCV)

McIntosh, E. David G.; Conway, Peter; Willingham, J; Hollingsworth, Rosalind; Lloyd, Adam

doi:10.1016/j.vaccine.2004.08.051

Cited by 70 publications

(55 citation statements)

References 27 publications

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“…A small study published over 20 years ago for invasive Haemophilus influenzae infection found costs for hospital admissions using base reference costs (£2300 without critical care, £4300 with) [30] to be not dissimilar to those found here, but this comparison does not consider inflation. Costs of hospital admissions for invasive pneumococcal infection (£903-£1547, depending on clinical presentation) [20] and invasive meningococcal infection (£2337) [31] have been produced for cost--effectiveness estimates and are also not widely different from our estimates for invasive GAS. However, the lack of a case list independent to hospital admission data prevents such aggregate studies accounting for variance in costs at an individual level.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 3400 (92% of total cases) represented primary admissions, of which 227 involved transfers between hospitals and 593 (17%) had ≥1 secondary admission. The median interval between primary discharge and secondary admission was 9 days (interquartile [IQR] range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Of the 3383 primary admissions which could ultimately be costed, 391 (11.6%) represented nosocomial infections.…”

Section: Linkage Of Cases To Hospital Admissionsmentioning

confidence: 99%

“…The societal costs of GAS pharyngitis in an area of the US have been estimated to be $205 per case [13] but the cost of hospital admissions associated with invasive GAS infection are currently unknown. Methods to estimate the cost of hospital admissions for infections can either utilise the actual billing cost [14][15][16] or use unit costs based on either the type of admission [17,18] or a diagnosis resource group [19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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The cost of hospital care for management of invasive group A streptococcal infections in England

et al. 2014

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SUMMARYThe objective of this study was to estimate the direct financial costs of hospital care for management of invasive group A streptococcal infections using hospital records for cases diagnosed in England. We linked laboratory--confirmed cases (n=3,696) identified through national surveillance to hospital episode statistics and reimbursement codes. From these codes we estimated the direct hospital costs of admissions. Almost all notified invasive GAS cases (92% of 3696) were successfully matched to a primary hospital admission. Of these, secondary admissions (within 30 days of primary admission) were further identified for 593 (17%). After exclusion of nosocomial cases (12%), the median costs of primary and secondary hospital admissions were estimated by subgroup analysis as £1984 -£2212 per case, totalling £4.43 -£6.34 million per year in England. With adjustment for unmatched cases this equated to £4.84 -£6.93 million per year. Adults aged 16-64 years accounted for 48% of costs but only 40% of cases, largely due to an increased number of surgical procedures. The direct costs of hospital admissions for invasive GAS infection are substantial. These estimated costs will contribute to a full assessment of the total economic burden of invasive GAS infection as a means to assess potential savings through prevention measures.(199 words) 3

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Section: Discussionmentioning

confidence: 99%

Section: Linkage Of Cases To Hospital Admissionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The cost of hospital care for management of invasive group A streptococcal infections in England

et al. 2014

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“…Finally, indirect effect by herd immunity of PCVs was not measured. The estimation of this effect can have a significant clinical impact on a non-vaccinated pediatric population, may decrease the severity given the reduction of invasive serotypes circulation, and eventually also may prevent disease in a nonvaccinated population [61][62][63][64]. However, including this estimation could increase the uncertainty of the model, especially when we do not have exact estimations.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

Mezones‐Holguín

Bolaños-Díaz

Fiestas

et al. 2014

J Infect Dev Ctries

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Introduction: Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 yearsold. Methodology: A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. Results: The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, andUSD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). Conclusions: PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.

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“…1 Since the introduction of PCVs in children, indirect protection of unvaccinated populations against invasive pneumococcal disease (IPD) has been clearly demonstrated. [3][4][5][6][7][8][9] Despite a partial replacement by non-vaccine types, these studies have revealed a relevant decrease in the overall pneumococcal disease burden in all age groups.…”

Section: Introductionmentioning

confidence: 99%

Herd effects of child vaccination with pneumococcal conjugate vaccine against pneumococcal non-invasive community-acquired pneumonia: What is the evidence?

Werkhoven

2016

Human Vaccines & Immunotherapeutics

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Pneumococcal pneumonia in the UK—how herd immunity affects the cost-effectiveness of 7-valent pneumococcal conjugate vaccine (PCV)

Cited by 70 publications

References 27 publications

The cost of hospital care for management of invasive group A streptococcal infections in England

The cost of hospital care for management of invasive group A streptococcal infections in England

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

Herd effects of child vaccination with pneumococcal conjugate vaccine against pneumococcal non-invasive community-acquired pneumonia: What is the evidence?

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