The cost-effectiveness of starting 23-valent pneumococcal polysaccharide vaccine and influenza vaccination at 50 vs. 65 years: A comparative modelling study
•We compared strategies of influenza and 23-valent polysaccharide vaccine (PPV23).•When compared with no vaccine, all vaccine strategies were cost-effective.•The earlier age of PPV23 was cost-effective in comparison with current programme.•Our findings could help inform design and implementation of...
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| Veröffentlicht in: | Vaccine 2022-02, Vol.40 (9), p.1282-1288 |
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| creator | Ding, Hanyue Huang, Junjie Ngai, Chun Ho Sun, Qingjie Kwok, Kin-On Wang, Harry HX Chong, Marc Wong, Martin CS |
| description | •We compared strategies of influenza and 23-valent polysaccharide vaccine (PPV23).•When compared with no vaccine, all vaccine strategies were cost-effective.•The earlier age of PPV23 was cost-effective in comparison with current programme.•Our findings could help inform design and implementation of vaccination strategies.
Pneumococcal infection is a leading cause of morbidity and mortality. We aimed to evaluate the cost-effectiveness of 23-valent polysaccharide vaccine (PPV23) together with influenza vaccination or pneumococcal vaccination alone in adults starting from 50 years vs. 65 years in Hong Kong.
A hypothetical population of 100,000 older adults was included in a Markov model with age ranging from 50 to 85 years to calculate the cost and quality-adjusted life-years (QALYs) gained for vaccination strategies, including: (1) annual influenza vaccine and PPV23 at 50 and 65 years; (2) annual influenza vaccine and PPV23 at 65 years (similar with the current vaccination programme); (3) PPV23 at 50 and 65 years; (4) PPV23 at 65 years; and (5) no vaccination. We evaluated the incremental cost-effectiveness ratio (ICER) and used Monte Carlo simulation for probabilistic sensitivity analysis. The cost-effectiveness threshold was extracted from previous literature.
In comparison with no vaccination, all strategies were cost-effective with ICERs less than the threshold (US$24,302 per QALY gained). When compared with no vaccination, strategies 1–4 saved US$ 49.5, US$ 94.9, US$ 584.3, and US$ 1114.2 to gain one QALY respectively. In comparison with strategy 2, strategy 1 spent US$ 195.3 to gain one QALY, whilst strategies 3 and 4 showed less effectiveness with increased costs.
All vaccination strategies were cost-effective, among which the strategy of PPV23 at 50/65 years with annual influenza vaccine was cost-effective even in comparison with current vaccination programme. These findings could help inform the design and implementation of vaccination strategies. |
| doi_str_mv | 10.1016/j.vaccine.2022.01.033 |
| format | Article |
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Pneumococcal infection is a leading cause of morbidity and mortality. We aimed to evaluate the cost-effectiveness of 23-valent polysaccharide vaccine (PPV23) together with influenza vaccination or pneumococcal vaccination alone in adults starting from 50 years vs. 65 years in Hong Kong.
A hypothetical population of 100,000 older adults was included in a Markov model with age ranging from 50 to 85 years to calculate the cost and quality-adjusted life-years (QALYs) gained for vaccination strategies, including: (1) annual influenza vaccine and PPV23 at 50 and 65 years; (2) annual influenza vaccine and PPV23 at 65 years (similar with the current vaccination programme); (3) PPV23 at 50 and 65 years; (4) PPV23 at 65 years; and (5) no vaccination. We evaluated the incremental cost-effectiveness ratio (ICER) and used Monte Carlo simulation for probabilistic sensitivity analysis. The cost-effectiveness threshold was extracted from previous literature.
In comparison with no vaccination, all strategies were cost-effective with ICERs less than the threshold (US$24,302 per QALY gained). When compared with no vaccination, strategies 1–4 saved US$ 49.5, US$ 94.9, US$ 584.3, and US$ 1114.2 to gain one QALY respectively. In comparison with strategy 2, strategy 1 spent US$ 195.3 to gain one QALY, whilst strategies 3 and 4 showed less effectiveness with increased costs.
All vaccination strategies were cost-effective, among which the strategy of PPV23 at 50/65 years with annual influenza vaccine was cost-effective even in comparison with current vaccination programme. These findings could help inform the design and implementation of vaccination strategies.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2022.01.033</identifier><identifier>PMID: 35094867</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adults ; Aged ; Aged, 80 and over ; Cost analysis ; Cost-Benefit Analysis ; Cost-effective analysis ; Fatalities ; Humans ; Immunization ; Influenza ; Influenza, Human - prevention & control ; Markov chains ; Middle Aged ; Monte Carlo simulation ; Morbidity ; Mortality ; Older people ; Pneumococcal infection ; Pneumococcal Infections - epidemiology ; Pneumococcal Vaccines ; Polysaccharides ; Quality-Adjusted Life Years ; Sensitivity analysis ; Streptococcus infections ; Vaccination ; Vaccine ; Vaccines</subject><ispartof>Vaccine, 2022-02, Vol.40 (9), p.1282-1288</ispartof><rights>2022 Elsevier Ltd</rights><rights>Copyright © 2022 Elsevier Ltd. All rights reserved.</rights><rights>2022. Elsevier Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-e951b650250844b1b652280ab9f953a992451faf8534978cf4cfbb9c1e5a99d73</citedby><cites>FETCH-LOGICAL-c393t-e951b650250844b1b652280ab9f953a992451faf8534978cf4cfbb9c1e5a99d73</cites><orcidid>0000-0001-9977-0985 ; 0000-0001-5610-1298 ; 0000-0003-0976-3816 ; 0000-0002-2804-5433</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2629068140?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000,64390,64392,64394,72474</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35094867$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ding, Hanyue</creatorcontrib><creatorcontrib>Huang, Junjie</creatorcontrib><creatorcontrib>Ngai, Chun Ho</creatorcontrib><creatorcontrib>Sun, Qingjie</creatorcontrib><creatorcontrib>Kwok, Kin-On</creatorcontrib><creatorcontrib>Wang, Harry HX</creatorcontrib><creatorcontrib>Chong, Marc</creatorcontrib><creatorcontrib>Wong, Martin CS</creatorcontrib><title>The cost-effectiveness of starting 23-valent pneumococcal polysaccharide vaccine and influenza vaccination at 50 vs. 65 years: A comparative modelling study</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>•We compared strategies of influenza and 23-valent polysaccharide vaccine (PPV23).•When compared with no vaccine, all vaccine strategies were cost-effective.•The earlier age of PPV23 was cost-effective in comparison with current programme.•Our findings could help inform design and implementation of vaccination strategies.
Pneumococcal infection is a leading cause of morbidity and mortality. We aimed to evaluate the cost-effectiveness of 23-valent polysaccharide vaccine (PPV23) together with influenza vaccination or pneumococcal vaccination alone in adults starting from 50 years vs. 65 years in Hong Kong.
A hypothetical population of 100,000 older adults was included in a Markov model with age ranging from 50 to 85 years to calculate the cost and quality-adjusted life-years (QALYs) gained for vaccination strategies, including: (1) annual influenza vaccine and PPV23 at 50 and 65 years; (2) annual influenza vaccine and PPV23 at 65 years (similar with the current vaccination programme); (3) PPV23 at 50 and 65 years; (4) PPV23 at 65 years; and (5) no vaccination. We evaluated the incremental cost-effectiveness ratio (ICER) and used Monte Carlo simulation for probabilistic sensitivity analysis. The cost-effectiveness threshold was extracted from previous literature.
In comparison with no vaccination, all strategies were cost-effective with ICERs less than the threshold (US$24,302 per QALY gained). When compared with no vaccination, strategies 1–4 saved US$ 49.5, US$ 94.9, US$ 584.3, and US$ 1114.2 to gain one QALY respectively. In comparison with strategy 2, strategy 1 spent US$ 195.3 to gain one QALY, whilst strategies 3 and 4 showed less effectiveness with increased costs.
All vaccination strategies were cost-effective, among which the strategy of PPV23 at 50/65 years with annual influenza vaccine was cost-effective even in comparison with current vaccination programme. These findings could help inform the design and implementation of vaccination strategies.</description><subject>Adults</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>Cost-effective analysis</subject><subject>Fatalities</subject><subject>Humans</subject><subject>Immunization</subject><subject>Influenza</subject><subject>Influenza, Human - prevention & control</subject><subject>Markov chains</subject><subject>Middle Aged</subject><subject>Monte Carlo simulation</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Older people</subject><subject>Pneumococcal infection</subject><subject>Pneumococcal Infections - epidemiology</subject><subject>Pneumococcal Vaccines</subject><subject>Polysaccharides</subject><subject>Quality-Adjusted Life Years</subject><subject>Sensitivity analysis</subject><subject>Streptococcus infections</subject><subject>Vaccination</subject><subject>Vaccine</subject><subject>Vaccines</subject><issn>0264-410X</issn><issn>1873-2518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc-K1TAUxosoznX0EZSAGzetJ0nT27iRYfAfDLgZwV1I0xMnlzapSVu48y6Cz-KTmXKvLty4OuHkd873cb6ieE6hokCb14dq1cY4jxUDxiqgFXD-oNjRds9LJmj7sNgBa-qypvD1oniS0gEABKfycXHBBci6bfa74sftHRIT0lyitWhmt6LHlEiwJM06zs5_I4yXqx7Qz2TyuIzBBGP0QKYwHFP2cKej65Gc7RDte-K8HRb09_rc1bMLnuiZCCBrqkgjfv08oo7pDbnK6uOko96kyRh6HIZNNM1Lf3xaPLJ6SPjsXC-LL-_f3V5_LG8-f_h0fXVTGi55ti4F7RoBTEBb1932ZqwF3UkrBddSslpQq20reC33rbG1sV0nDUWRP_s9vyxenfZOMXxfMM1qdMlkJ9pjWJJiDasZQCOajL78Bz2EJfrsbqMkNC2tIVPiRJkYUopo1RTdqONRUVBbfuqgzgdTW34KqMr55bkX5-1LN2L_d-pPYBl4ewIwn2N1GFUyDr3B3sUcn-qD-4_Ebx8JsGQ</recordid><startdate>20220223</startdate><enddate>20220223</enddate><creator>Ding, Hanyue</creator><creator>Huang, Junjie</creator><creator>Ngai, Chun Ho</creator><creator>Sun, Qingjie</creator><creator>Kwok, Kin-On</creator><creator>Wang, Harry HX</creator><creator>Chong, Marc</creator><creator>Wong, Martin CS</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T2</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9977-0985</orcidid><orcidid>https://orcid.org/0000-0001-5610-1298</orcidid><orcidid>https://orcid.org/0000-0003-0976-3816</orcidid><orcidid>https://orcid.org/0000-0002-2804-5433</orcidid></search><sort><creationdate>20220223</creationdate><title>The cost-effectiveness of starting 23-valent pneumococcal polysaccharide vaccine and influenza vaccination at 50 vs. 65 years: A comparative modelling study</title><author>Ding, Hanyue ; Huang, Junjie ; Ngai, Chun Ho ; Sun, Qingjie ; Kwok, Kin-On ; Wang, Harry HX ; Chong, Marc ; Wong, Martin CS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-e951b650250844b1b652280ab9f953a992451faf8534978cf4cfbb9c1e5a99d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>Cost-effective analysis</topic><topic>Fatalities</topic><topic>Humans</topic><topic>Immunization</topic><topic>Influenza</topic><topic>Influenza, Human - prevention & control</topic><topic>Markov chains</topic><topic>Middle Aged</topic><topic>Monte Carlo simulation</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Older people</topic><topic>Pneumococcal infection</topic><topic>Pneumococcal Infections - epidemiology</topic><topic>Pneumococcal Vaccines</topic><topic>Polysaccharides</topic><topic>Quality-Adjusted Life Years</topic><topic>Sensitivity analysis</topic><topic>Streptococcus infections</topic><topic>Vaccination</topic><topic>Vaccine</topic><topic>Vaccines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ding, Hanyue</creatorcontrib><creatorcontrib>Huang, Junjie</creatorcontrib><creatorcontrib>Ngai, Chun Ho</creatorcontrib><creatorcontrib>Sun, Qingjie</creatorcontrib><creatorcontrib>Kwok, Kin-On</creatorcontrib><creatorcontrib>Wang, Harry HX</creatorcontrib><creatorcontrib>Chong, Marc</creatorcontrib><creatorcontrib>Wong, Martin CS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Healthcare Administration Database</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ding, Hanyue</au><au>Huang, Junjie</au><au>Ngai, Chun Ho</au><au>Sun, Qingjie</au><au>Kwok, Kin-On</au><au>Wang, Harry HX</au><au>Chong, Marc</au><au>Wong, Martin CS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The cost-effectiveness of starting 23-valent pneumococcal polysaccharide vaccine and influenza vaccination at 50 vs. 65 years: A comparative modelling study</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2022-02-23</date><risdate>2022</risdate><volume>40</volume><issue>9</issue><spage>1282</spage><epage>1288</epage><pages>1282-1288</pages><issn>0264-410X</issn><eissn>1873-2518</eissn><abstract>•We compared strategies of influenza and 23-valent polysaccharide vaccine (PPV23).•When compared with no vaccine, all vaccine strategies were cost-effective.•The earlier age of PPV23 was cost-effective in comparison with current programme.•Our findings could help inform design and implementation of vaccination strategies.
Pneumococcal infection is a leading cause of morbidity and mortality. We aimed to evaluate the cost-effectiveness of 23-valent polysaccharide vaccine (PPV23) together with influenza vaccination or pneumococcal vaccination alone in adults starting from 50 years vs. 65 years in Hong Kong.
A hypothetical population of 100,000 older adults was included in a Markov model with age ranging from 50 to 85 years to calculate the cost and quality-adjusted life-years (QALYs) gained for vaccination strategies, including: (1) annual influenza vaccine and PPV23 at 50 and 65 years; (2) annual influenza vaccine and PPV23 at 65 years (similar with the current vaccination programme); (3) PPV23 at 50 and 65 years; (4) PPV23 at 65 years; and (5) no vaccination. We evaluated the incremental cost-effectiveness ratio (ICER) and used Monte Carlo simulation for probabilistic sensitivity analysis. The cost-effectiveness threshold was extracted from previous literature.
In comparison with no vaccination, all strategies were cost-effective with ICERs less than the threshold (US$24,302 per QALY gained). When compared with no vaccination, strategies 1–4 saved US$ 49.5, US$ 94.9, US$ 584.3, and US$ 1114.2 to gain one QALY respectively. In comparison with strategy 2, strategy 1 spent US$ 195.3 to gain one QALY, whilst strategies 3 and 4 showed less effectiveness with increased costs.
All vaccination strategies were cost-effective, among which the strategy of PPV23 at 50/65 years with annual influenza vaccine was cost-effective even in comparison with current vaccination programme. These findings could help inform the design and implementation of vaccination strategies.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>35094867</pmid><doi>10.1016/j.vaccine.2022.01.033</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9977-0985</orcidid><orcidid>https://orcid.org/0000-0001-5610-1298</orcidid><orcidid>https://orcid.org/0000-0003-0976-3816</orcidid><orcidid>https://orcid.org/0000-0002-2804-5433</orcidid></addata></record> |
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| subjects | Adults Aged Aged, 80 and over Cost analysis Cost-Benefit Analysis Cost-effective analysis Fatalities Humans Immunization Influenza Influenza, Human - prevention & control Markov chains Middle Aged Monte Carlo simulation Morbidity Mortality Older people Pneumococcal infection Pneumococcal Infections - epidemiology Pneumococcal Vaccines Polysaccharides Quality-Adjusted Life Years Sensitivity analysis Streptococcus infections Vaccination Vaccine Vaccines |
| title | The cost-effectiveness of starting 23-valent pneumococcal polysaccharide vaccine and influenza vaccination at 50 vs. 65 years: A comparative modelling study |
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