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. 2022 Nov 30;18(6):2101333.
doi: 10.1080/21645515.2022.2101333. Epub 2022 Aug 2.

Cost-utility analysis of the universal pneumococcal vaccination programme for older adults in Norway

Liv Solvår Nymark  1 , Jacob Dag Berild  1 , Trude Marie Lyngstad  1 , Brita Askeland Winje  1 , Didrik Frimann Vestrheim  1 , Ingeborg Aaberge  1 , Lene Kristine Juvet  1 , Ellen Wolff  2
Affiliations

Cost-utility analysis of the universal pneumococcal vaccination programme for older adults in Norway

Liv Solvår Nymark et al. Hum Vaccin Immunother. .

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Hum Vaccin Immunother. 2023 Dec 31;19(1):2177067. doi: 10.1080/21645515.2023.2177067. Epub 2023 Feb 27. Hum Vaccin Immunother. 2023. PMID: 36847754 Free PMC article. No abstract available.

Abstract

The aim of this study was to establish whether the universal pneumococcal vaccination for older adults in Norway is likely to be cost-effective from the perspective of the health care provider. A decision tree model developed by the Public Health Agency of Sweden was adapted to the Norwegian setting. Two cohorts, consisting of 65-year-olds and 75-year-olds grouped into vaccinated and unvaccinated, were followed over a 5-year time horizon. In the base case, the 23-valent polysaccharide vaccine (PPV23) was used while the 13-valent pneumococcal conjugate vaccine (PCV13) was included in scenario analyses only. The costs and health benefits (measured in quality adjusted life years (QALY) gained) were compared in the two cohorts between the vaccinated and unvaccinated groups. The impact of indirect effects of the vaccine, such as herd immunity and serotype replacement, were not investigated. The relative importance of change in price was assessed by performing one-way sensitivity analyses. Under base-case assumptions, the programme for the 75-year-old cohort is expected to be dominant (cost-effective) from the health care perspective at the current maximal pharmacy retail price and at 75% vaccination coverage. In comparison, for the 65-year-old cohort the cost per QALY gained is approximately NOK 601,784 (EUR 61,281) under the base-case assumptions. A reduction in the cost of the vaccine to one quarter of its current level also brings the cost per QALY gained within the acceptable ranges in a Norwegian context for both the 65- and 75-year-old cohorts. There is no exact cost-effectiveness threshold in Norway. However, introducing a vaccination programme against pneumococcal disease for 65-year-olds in Norway is likely to fall within the acceptable range while for the 75-year-old cohort the universal programme appears to be dominant (cost-effective).

Keywords: Pneumococcal vaccine; Streptococcus pneumonia; cost-effectiveness.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Simplified schematic overview of the decision tree model.
See this image and copyright information in PMC

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