Cost-effectiveness of administering 13-valent pneumococcal conjugate vaccine in addition to 23-valent pneumococcal polysaccharide vaccine to adults with immunocompromising conditions.

摘要: Abstract Background In June, 2012 a single dose of 13-valent pneumococcal conjugate vaccine (PCV13) was added to the recommendation for immunocompromised adults who were previously recommended receive only 23-valent polysaccharide (PPSV23). PCV13 may be more effective, though it covers fewer disease-causing strains. Objective We examined incremental cost-effectiveness adding one pre-2012 PPSV23 with 4 immunocompromising conditions are at increased risk disease: HIV/AIDS, hematologic cancer, solid organ transplants, and end stage renal disease. Methods used probabilistic model following cohort 302,397 adults. vaccination coverage disease incidence data specific each condition. Assumptions about effectiveness based on two randomized controlled trials several observational studies conducted among HIV-infected Because no such have been other populations, we made further assumptions relative in those groups. Cost-effectiveness ratios determined condition all groups total. Results Our indicated that United States would cost $16 million (in 2009$) but provide off-setting savings $21 per from societal perspective. These come largely decreased medical costs This prevent 57 cases invasive disease, 619 hospitalized all-cause pneumonia, avert 93 deaths, save 1360 quality adjusted life years cohort. Conclusion The addition doses selected potentially reduces both costs.