Pneumococcal Vaccination at Age 50 Prevents the Most Disease
But cost of giving pneumococcal vaccines to all 50-year-olds exceeds $250,000 per QALY
MONDAY, March 4, 2019 (Pharmacist's Briefing) -- Recommending pneumococcal vaccination for all 50-year-olds prevents the most disease in underserved minorities and the general population, but the cost exceeds $250,000 per quality-adjusted life-year (QALY) gained, according to a study published online March 4 in Vaccine.
Angela R. Wateska, M.P.H., from the University of Pittsburgh School of Medicine, and colleagues estimated the cost-effectiveness of U.S. pneumococcal vaccination policies in a hypothetical 50-year-old underserved minority cohort and general population cohort. Strategies for vaccination included receiving one or both available pneumococcal vaccines based on criteria specific to age or chronic conditions.
The researchers found that giving both pneumococcal vaccines to all 50-year-olds prevented the most disease in both black and general population 50-year-olds, at a cost of >$250,000 per QALY gained. In either population, current U.S. Centers for Disease Control and Prevention recommendations were economically favorable when analyses assumed polysaccharide vaccine was ineffective against nonbacteremic pneumococcal pneumonia (NBP). Giving polysaccharide vaccine to all 50-year-olds cost <$100,000/QALY if polysaccharide vaccine was effective against NBP or if less complex age-based vaccination recommendations resulted in increased vaccine uptake; in black cohorts, this effect was more pronounced.
"Vaccinating the general population against pneumococcal disease at age 50 doesn't quite reach the U.S. benchmark for cost-effectiveness, but it's not too far off," a coauthor said in a statement. "It isn't unreasonable to assume that vaccination rates will climb even higher than 33 percent -- and each percent gained will improve the cost-effectiveness."