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Vaccine. 2011 Oct 13;29(44):7644-50. doi: 10.1016/j.vaccine.2011.08.006. Epub 2011 Aug 18.

Cost-effectiveness of the introduction of the pneumococcal polysaccharide vaccine in elderly Colombian population.

Author information

1
Epidemiology and Public Health Evaluation Group, Department of Public Health, Faculty of Medicine, Universidad Nacional de Colombia, Carrera 30 # 45-03, Office 150, Bogotá D.C., Colombia. cacastanedao@unal.edu.co

Abstract

BACKGROUND:

Streptococcus pneumoniae causes community-acquired pneumonia, otitis media and meningitis, with higher incidences at the extremes of life. PPV-23 vaccine is widely used in prevention of pneumonia and invasive pneumococcal disease in older adults in developed countries. We developed an evaluation of cost-effectiveness of implementing PPV-23 in Colombian population over 60 years.

METHODS:

The number of cases of pneumonia and meningitis in patients over 60 years and the proportion by S. pneumoniae was estimated based on a review of literature. A decision tree model with a 5-year time horizon was built to evaluate the cost-effectiveness of the implementation of the PPV-23 in this population. Direct health care costs of out- and in-patients were calculated based on expenditure records from the Bogota public health system. Incremental cost-effectiveness ratios per life saved and per year of life gained were estimated based on the decision tree model. Deterministic and probabilistic sensitivity analyses were performed.

RESULTS:

Without vaccination 4460 (range 2384-8162) bacteremic pneumococcal pneumonias and 141 (range 73-183) pneumococcal meningitis would occur among people over 60 years old in Colombia. In the first year, vaccination with PPV-23 at US$8/dose would save 480 (range 100-1753) deaths due to Invasive and non-invasive pneumococcal disease. Vaccination would results in US$3400/deaths averted (range US$1028-10,862) and US$1514/life years gained (range US$408-5404).

CONCLUSION:

Vaccination with PPV-23 in over 60 years is a highly cost-effective public health measure in Colombia. Despite some limitations, the results are robust, and may help developing countries to perform informed decisions about the introduction of the vaccine.

PMID:
21854825
DOI:
10.1016/j.vaccine.2011.08.006
[Indexed for MEDLINE]

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