Martikainen Janne A, Soini Erkki J, Laine Juha, Ahman Heidi, Postila Ville, Klemets Peter
ESiOR Oy, Kuopio, Finland.
J Eval Clin Pract. 2014 Aug;20(4):333-41. doi: 10.1111/jep.12131. Epub 2014 May 10.
RATIONALE, AIMS AND OBJECTIVES: Invasive pneumococcal diseases (IPD) are associated with substantial burden in adults (≥50 years). Moreover, adults with vascular, metabolic or respiratory diseases have been shown to have a 3-6 times higher risk of IPD when compared with their healthy controls. These persons at higher risk are likely to benefit most from pneumococcal vaccinations. The 13-valent pneumococcal conjugate vaccine (PCV13) was recently introduced to prevent the 13 most prevalent serotypes causing invasive pneumococcal disease in adults. The objective of this study was to estimate the expected 5-year economic impact of targeted PCV13 vaccination compared with no vaccination in Finnish adults (≥50 years) at moderate or high risk for IPD.
A budget impact model was developed to predict the impact of PCV13 vaccination in terms of the costs and IPD events avoided for years 2012-2016.
Approximately 35% of the 2.2 million Finns over 50 years of age can be considered to be at moderate or high risk for IPD because of underlying chronic medical conditions. Vaccination of these people with PCV13 could provide an estimated net budget savings of about €218 million compared with the current no-vaccination situation over the next 5 years. Among the risk groups considered, the largest absolute net savings (€66.2 million) could be expected to be obtained by vaccinating people with heart disease, due to its high prevalence in the target population.
In Finland, the immunization with PCV13 vaccine, of adults (≥50 years) at moderate and high risk of IPD, is estimated to lead to substantial cost savings in the 5 years after vaccination.
原理、目的和目标:侵袭性肺炎球菌疾病(IPD)在成年人(≥50岁)中造成了沉重负担。此外,患有血管、代谢或呼吸系统疾病的成年人患IPD的风险比健康对照者高3至6倍。这些高危人群可能从肺炎球菌疫苗接种中获益最大。13价肺炎球菌结合疫苗(PCV13)最近被引入,用于预防导致成年人侵袭性肺炎球菌疾病的13种最常见血清型。本研究的目的是评估与未接种疫苗相比,针对芬兰中度或高度IPD风险的成年人(≥50岁)进行PCV13靶向接种疫苗预计产生的5年经济影响。
建立了一个预算影响模型,以预测2012 - 2016年期间PCV13疫苗接种在成本和避免的IPD事件方面的影响。
由于潜在的慢性疾病,在220万50岁以上的芬兰人中,约35%可被视为中度或高度IPD风险人群。与目前未接种疫苗的情况相比,在未来5年中用PCV13为这些人接种疫苗估计可节省约2.18亿欧元的净预算。在考虑的风险组中,由于心脏病在目标人群中患病率高,预计通过为心脏病患者接种疫苗可获得最大的绝对净节省(6620万欧元)。
在芬兰,估计对中度和高度IPD风险的成年人(≥50岁)接种PCV13疫苗,在接种疫苗后的5年内可大幅节省成本。