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Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects

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Abstract

In Germany, the seven-valent conjugate vaccine Prevenar is recommended for use in children at high risk of pneumococcal disease. Recent data suggest that giving conjugate vaccine to all children may lead to a decline in pneumococcal disease in unvaccinated adults, a phenomenon known as herd immunity. This analysis evaluated the cost and economic consequences in Germany of vaccinating (1) children at high risk, (2) all children when considering only benefits for vaccinated individuals and (3) all children when also considering herd immunity benefits. Costs in the model included vaccination, management of meningitis, bacteraemia, pneumonia and acute otitis media, insurance payments to parents and the costs of care for long-term disabilities. The model estimated that the cost-effectiveness of vaccination would be 38,222 euros per life year gained in children at high risk and 100,636 euros per life year gained in all children when not considering herd immunity. When considering herd immunity effects, the model estimated that offering vaccination for all children would reduce adult deaths by 3,027 per year, and vaccination would be broadly cost neutral. The findings are sensitive to the effect of conjugate vaccine on the rates of pneumonia and invasive disease in the elderly. If the herd immunity effect of conjugate vaccination in Germany is similar to that observed elsewhere, offering vaccine to all children will be more attractive than the current policy of restricting vaccination to children at high risk of pneumococcal disease.

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Author notes

  1. Nishma Patel

    Present address: Health Economics and Policy Research Unit, University of Glamorgan, Pontypridd, Wales

  2. David A. Scott

    Present address: Oxford Outcomes, Oxford, UK

Authors and Affiliations

  1. Fourth Hurdle Consulting Ltd, Holborn Tower, 137-144 High Holborn, London, WC1V 6PL, UK

    Adam Lloyd, Nishma Patel & David A. Scott

  2. Wyeth Pharmaceuticals, Münster, Germany

    Claus Runge

  3. Universität Hannover, Hannover, Germany

    Christa Claes

  4. Childrens’ Hospital, Goethe University, Frankfurt, Germany

    Markus Rose

Authors
  1. Adam Lloyd
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  2. Nishma Patel
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  3. David A. Scott
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  4. Claus Runge
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  5. Christa Claes
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  6. Markus Rose
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Correspondence to Adam Lloyd.

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Lloyd, A., Patel, N., Scott, D.A. et al. Cost-effectiveness of heptavalent conjugate pneumococcal vaccine (Prevenar) in Germany: considering a high-risk population and herd immunity effects. Eur J Health Econ 9, 7–15 (2008). https://doi.org/10.1007/s10198-006-0013-6

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  • DOI: https://doi.org/10.1007/s10198-006-0013-6

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