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Cost effectiveness analysis of heptavalent pneumococcal conjugate vaccine in Germany considering herd immunity effects

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Abstract

Background

In Germany the heptavalent pneumococcal conjugate vaccine (PCV7) has been recommended as a general infant vaccination since 2006. Data from similar programmes in the USA have reported a reduction of pneumococcal diseases in both vaccinated and unvaccinated populations, suggesting herd immunity effects. This study analyses the cost-effectiveness of a general vaccination with PCV7 in Germany based on these findings.

Methods

A Markov model adapts efficacy and herd immunity data to the German population. Further main model inputs are incidence, vaccination uptake, serotype distribution, case fatality rates, and vaccination and health-care costs.

Results

A general vaccination with PCV7 would avoid about 232,000 pneumococcal infections and 1,879 premature deaths per year in Germany. From the health-care payer's perspective, direct cost savings would outweigh vaccination expenditures by a ratio of 1:1.16. The sensitivity analysis shows that these estimates are quite conservative.

Conclusion

Based on the health-economic evaluation, the authors recommend the continuation of the general recommendation of PCV7 according to the 3 + 1 schedule within the German Statutory Health Insurance.

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Acknowledgments

The authors would like to thank the members of the German Advisory Board Prevenar® PCV7 for their valuable comments.

Competing interest

This study was supported by an unrestricted educational grant from Wyeth Pharma, Münster, Germany.

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Authors and Affiliations

  1. Centre for Health Economics and Health System Research, Leibniz University of Hannover, Hannover, Germany

    Christa Claes & Johann-Matthias Graf von der Schulenburg

  2. Institute of Medical Microbiology, National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany

    Ralf René Reinert

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  1. Christa Claes
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Correspondence to Christa Claes.

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Claes, C., Reinert, R.R. & von der Schulenburg, JM.G. Cost effectiveness analysis of heptavalent pneumococcal conjugate vaccine in Germany considering herd immunity effects. Eur J Health Econ 10, 25–38 (2009). https://doi.org/10.1007/s10198-008-0098-1

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