1439. The Cost-Effectiveness of Vaccinating Adults at Increased Risk of Pneumococcal Disease Against Pneumococcal Disease in The Netherlands

Abstract

Background. Tere is currently no data on the age- and risk-group-specifc cost-effectiveness of the 13 valent pneumococcal vaccine (PCV13) compared with the 23 valent polysaccharide vaccine (PPV23). The aim of this study was to evaluate the cost-effectiveness of vaccinating these specifc groups against pneumococcal disease. Methods. A previously published and independently validated (by The Dutch National Health-Care Institute) age-and risk-group-specifc Markov-type model was used to compare the cost-effectiveness of PCV13 vaccination vs. PPV23 vaccination of all adults at increased risk of pneumococcal disease (i.e., adults with underlying disease and those ≥50 years). Efcacy estimates for PCV13 were extrapolated from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA). Efcacy estimates for PPV23 were based on systematic literature reviews and other published data. Results. At list price (€68.56 for PCV13 and €19.99 for PPV23), vaccination of all adults at increased risk of pneumococcal disease resulted in an ICER of €20,186/QALY, while vaccinating those with chronic medical conditions (moderate risk) and immu-nocompromising conditions (high risk) resulted in an ICER of