Volume 10, Number 1, 25-38, DOI: 10.1007/s10198-008-0098-1

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

Christa Claes, Ralf René Reinert and Johann-Matthias Graf von der Schulenburg

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Abstract

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.

Keywords  Pneumococcal conjugate vaccine (PCV7) - Herd immunity - Pneumococcal disease - Germany

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