Economic Evaluation of Immunisation Programme of 23-Valent Pneumococcal Polysaccharide Vaccine and the Inclusion of 13-Valent Pneumococcal Conjugate Vaccine in the List for Single-Dose Subsidy to the Elderly in Japan

摘要: Background Currently in Japan, both 23-valent pneumococcal polysaccharide vaccine (PPSV–23) and 13-valent conjugate (PCV–13) are available for the elderly prevention of S. pneumoniae-related diseases. PPSV–23 was approved 1988, while extended use PCV–13 adults aged 65 older June 2014. Despite these two vaccines being available, recently launched national immunisation programme only subsidised PPSV–23. The framework current lasts five years. population eligible shot 1st year those 65, 70, 75, 80, 85, 90, 95 ≥100. While from 2nd to 5th year, who will age 100 receive same shot. Methods We performed economic evaluations (1) evaluate efficiency alternative strategies single-dose programme, (2) investigate inclusion list programme. Three were created this study, namely: strategy, 80 (as “65–80 strategy”), (3) “≥65 strategy”). We constructed a Markov model depicting disease course pathways. transition probabilities, utility weights estimate quality adjusted life (QALY) treatment costs either calculated or cited literature. Cost per ¥8,116 (US$74; US$1 = ¥110) ¥10,776 (US$98) PCV–13. runs 15 years with one cycle after immunisation. Discounting at 3%. Results Compared 65–80 strategy cost less but gained less, incremental cost-effectiveness ratios (ICERs) ≥65 ¥5,025,000 (US$45,682) QALY gained. into subsidy has an ICER ¥377,000 (US$3,427) regardless diffusion level. These ICERs found be cost-effective since they lower than suggested criterion by WHO three times GDP (¥11,000,000 US$113,636 gained), which is benchmark used judging programmne. Conclusions The results suggest that switching including Japan value money.