Журнал инфектологии (Dec 2019)
Cost-effectiveness of vaccination against pneumococcal infection of adults at risk within the federal and regional programs
Abstract
The aim. of the work was to evaluate the cost-effectiveness of vaccination with the 13-vaIent pneumococcal conjugate vaccine (PCV13) and its combination with the 23-valent pneumococcal polysaccharide vaccine (PPV23) of immunocompetent adult patients with different levels of risk of pneumococcal infection.Material and methods. Cost-effectiveness analysis was carried out by a modeling method, with a horizon of 15 years from the position of the healthcare system, and. taking into account the social perspective. The analysis was performed, for 20, 40, and 60 year oId patients with 1, 2, and 3 risk factors. In accordance with national recommendations, the vaccination. regimen included, the introduction, of PC 1 dose of PPV23 one year later. In addition, the analysis was performed, for vaccination, with 1 dose of PCV13.The efficacy of PCV13 and PPV23 in different age groups corresponded, to the results of foreign studies, taking into account the data of a Russian study of the serotypic landscape of pneumococci with community-acquired, pneumonia, which required, hospitalization.The cost of treating pneumococcal infections was calculated. on the basis of the mandatory medical insurance rates in St. Petersburg for 2019. The cost of vaccination, for federal programs was calculated, on the basis of the PCV13 price of 1199 rubles per dose, and. for regional programs — 1518.63 rubles per dose. The cost of PPV23 in both, cases corresponded. to the weighted average price of auctions for 2019 (1639 rubles per dose).Indirect costs were calculated, on the basis of data on average wages in the Russian Federation, and. employment of citizens of various age groups.Costs and. life expectancy were discounted, at 3.5% per year.Results. The number of cases of infection prevented, and. the amount of costs averted, increase with increasing risk level. Moreover, with age, the number of deaths caused, by these diseases increases significantly. The volume of prevented, direct medical and. general costs per 1 vaccinated, patient varies from 0.41-2.95 thousand, rubles and. 1.00-6.82 thousand, rubles, respectively. Vaccination, of patients with 3 risk factors is most cost-effective.Conclusion. When analyzed, from the perspective of the healthcare system., vaccination, against pneumococcal infection with PCV13+PPV23 in 60-year-old. patients with at least 1 risk factor and. patients of any age with at least 2 risk factors can be considered as cost-effective. Vaccination with 1 dose of PCV13 of patients of any age with at least 1 risk factor in the analysis from the perspective of the healthcare system, can be considered, as a cost-effective intervention.
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