This study aimed to evaluate the cost-effectiveness of introducing 23-valent pneumococcal polysaccharide vaccine (PPV23) for elders into provincial immunization program in Zhejiang, China. From a societal perspective, a decision tree-Markov model was constructed to stimulate the economic and health consequences of Streptococcus pneumonae infection diseases in both 60-y-old and 70-y-old cohort, with one dose PPV23 vaccination and a coverage of 90% versus no vaccination. The model accounted for invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBP). Model parameters were obtained from up-to-date published literature and statistical data. The costs associated with vaccination and medical treatment, quality-adjusted life years (QALYs), the number of Spn infection cases averted, and the incremental cost-effectiveness ratio (ICER) were calculated. Both effects and costs were discounted by 3% annually. The sensitivity analysis was implemented to evaluate the robustness of the model. Compared to the no-vaccination, the PPV23 vaccination program could reduce the number of IPD case, NBP case, death by 9. 56%, 3. 93% and 6. 72% in the 60-y-old cohort. The corresponding figures for the 70-y-old cohort were 20. 96%, 30. 22%, and 15. 70%. The ICER was estimated at US 635. 31/QALY and US 69. 36/QALY for the 60-y-old and 70-y-old cohort, respectively, and these results were robust in sensitivity analyses. Introducing a vaccination program of PPV23 targeting both 60 y old and 70 y old was economical based on the parameters, having the potential to substantially reduce morbidity and mortality related to Spn and the related disease burden.
Yu et al. (Tue,) studied this question.