TY - JOUR

T1 - Cost effectiveness analysis of heptavalent pneumococcal conjugate vaccine in Germany considering herd immunity effects

AU - Claes, Christa

AU - Reinert, Ralf René

AU - Von Der Schulenburg, Johann Matthias Graf

N1 - Funding Information: This study was supported by an unrestricted educational grant from Wyeth Pharma, Münster, Germany.

PY - 2009/2

Y1 - 2009/2

N2 - Background: In Germany the heptavalent pneumococcal conjugate vaccine (PCV7) has been recommended as a general infant vaccination since 2006. Data from similar programmes in the USA have reported a reduction of pneumococcal diseases in both vaccinated and unvaccinated populations, suggesting herd immunity effects. This study analyses the cost-effectiveness of a general vaccination with PCV7 in Germany based on these findings. Methods: A Markov model adapts efficacy and herd immunity data to the German population. Further main model inputs are incidence, vaccination uptake, serotype distribution, case fatality rates, and vaccination and health-care costs. Results: A general vaccination with PCV7 would avoid about 232,000 pneumococcal infections and 1,879 premature deaths per year in Germany. From the health-care payer's perspective, direct cost savings would outweigh vaccination expenditures by a ratio of 1:1.16. The sensitivity analysis shows that these estimates are quite conservative. Conclusion: Based on the health-economic evaluation, the authors recommend the continuation of the general recommendation of PCV7 according to the 3 + 1 schedule within the German Statutory Health Insurance.

AB - Background: In Germany the heptavalent pneumococcal conjugate vaccine (PCV7) has been recommended as a general infant vaccination since 2006. Data from similar programmes in the USA have reported a reduction of pneumococcal diseases in both vaccinated and unvaccinated populations, suggesting herd immunity effects. This study analyses the cost-effectiveness of a general vaccination with PCV7 in Germany based on these findings. Methods: A Markov model adapts efficacy and herd immunity data to the German population. Further main model inputs are incidence, vaccination uptake, serotype distribution, case fatality rates, and vaccination and health-care costs. Results: A general vaccination with PCV7 would avoid about 232,000 pneumococcal infections and 1,879 premature deaths per year in Germany. From the health-care payer's perspective, direct cost savings would outweigh vaccination expenditures by a ratio of 1:1.16. The sensitivity analysis shows that these estimates are quite conservative. Conclusion: Based on the health-economic evaluation, the authors recommend the continuation of the general recommendation of PCV7 according to the 3 + 1 schedule within the German Statutory Health Insurance.

KW - Germany

KW - Herd immunity

KW - Pneumococcal conjugate vaccine (PCV7)

KW - Pneumococcal disease

UR - http://www.scopus.com/inward/record.url?scp=58149103494&partnerID=8YFLogxK

U2 - 10.1007/s10198-008-0098-1

DO - 10.1007/s10198-008-0098-1

M3 - Article

C2 - 18379830

AN - SCOPUS:58149103494

VL - 10

SP - 25

EP - 38

JO - European Journal of Health Economics

JF - European Journal of Health Economics

SN - 1618-7598

IS - 1

ER -