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Erschienen in: Journal of Community Health 1/2020

10.08.2019 | Original Paper

Cost-Effectiveness of Pneumococcal Vaccination and Uptake Improvement Programs in Underserved and General Population Adults Aged < 65 Years

verfasst von: Angela R. Wateska, Mary Patricia Nowalk, Chyongchiou J. Lin, Lee H. Harrison, William Schaffner, Richard K. Zimmerman, Kenneth J. Smith

Erschienen in: Journal of Community Health | Ausgabe 1/2020

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Abstract

In US adults aged < 65 years, pneumococcal vaccination is recommended when high-risk conditions are present, but vaccine uptake is low. Additionally, there are race-based differences in illness risk and vaccination rates. The cost-effectiveness of programs to improve vaccine uptake or of alternative vaccination policies to increase protection is unclear. A decision analysis compared, in US black and general population cohorts aged 50 years, the public health impact and cost-effectiveness of pneumococcal vaccination recommendations, without and with a vaccine uptake improvement program, and alternative population vaccine policies. Program-based uptake improvement (base case: 12.3% absolute increase, costing $1.78/eligible patient) was based on clinical trial data. US data informed population-specific pneumococcal risk. Vaccine effectiveness was estimated using Delphi panel and trial data. In both black and general population cohorts, an uptake improvement program for current vaccination recommendations was favored, costing $48,621 per QALY gained in black populations ($54,929/QALY in the general population) compared to current recommendations without a program. Alternative vaccination policies largely prevented less illness and were economically unfavorable. In sensitivity analyses, uptake programs were favored, at a $100,000/QALY threshold, unless they improved absolute vaccine uptake < 2.1% in blacks or < 2.6% in the general population. Results were robust in sensitivity analyses. Programs to increase adult pneumococcal vaccination uptake are economically reasonable compared to changes in vaccination recommendations, and more favorable in underserved minorities than in the general population. If addressing race-based health disparities is a priority, evidence-based programs to increase vaccination should be considered.
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Literatur
8.
Zurück zum Zitat Sisk, J. E., Whang, W., Butler, J. C., Sneller, V.-P., & Whitney, C. G. (2003). Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: Role of comorbid conditions and race. Annals of Internal Medicine,138(12), 960–968.CrossRefPubMed Sisk, J. E., Whang, W., Butler, J. C., Sneller, V.-P., & Whitney, C. G. (2003). Cost-effectiveness of vaccination against invasive pneumococcal disease among people 50 through 64 years of age: Role of comorbid conditions and race. Annals of Internal Medicine,138(12), 960–968.CrossRefPubMed
9.
Zurück zum Zitat Smith, K. J., Wateska, A. R., Nowalk, M. P., Raymund, M., Nuorti, J. P., & Zimmerman, R. K. (2012). Cost-effectiveness of adult vaccination strategies using pneumococcal conjugate vaccine compared with pneumococcal polysaccharide vaccine. Journal of the American Medical Association,307(8), 804–812.PubMed Smith, K. J., Wateska, A. R., Nowalk, M. P., Raymund, M., Nuorti, J. P., & Zimmerman, R. K. (2012). Cost-effectiveness of adult vaccination strategies using pneumococcal conjugate vaccine compared with pneumococcal polysaccharide vaccine. Journal of the American Medical Association,307(8), 804–812.PubMed
14.
Zurück zum Zitat Arias, E., Heron, M., & Xu, J. (2016). United States life tables, 2012. National Vital Statistics Reports,65(8), 1–65.PubMed Arias, E., Heron, M., & Xu, J. (2016). United States life tables, 2012. National Vital Statistics Reports,65(8), 1–65.PubMed
15.
Zurück zum Zitat Said, M. A., Johnson, H. L., Nonyane, B. A. S., Deloria-Knoll, M., & O’Brien, K. L. (2013). Estimating the burden of pneumococcal pneumonia among adults: A systematic review and meta-analysis of diagnostic techniques. PLoS ONE,8(4), e60273.CrossRefPubMedPubMedCentral Said, M. A., Johnson, H. L., Nonyane, B. A. S., Deloria-Knoll, M., & O’Brien, K. L. (2013). Estimating the burden of pneumococcal pneumonia among adults: A systematic review and meta-analysis of diagnostic techniques. PLoS ONE,8(4), e60273.CrossRefPubMedPubMedCentral
17.
19.
Zurück zum Zitat Gold, M. R., Franks, P., McCoy, K., & Fryback, D. G. (1998). Toward consistency in cost-utility analyses: Using national measures to create condition-specific values. Medical Care,36(6), 778–792.CrossRefPubMed Gold, M. R., Franks, P., McCoy, K., & Fryback, D. G. (1998). Toward consistency in cost-utility analyses: Using national measures to create condition-specific values. Medical Care,36(6), 778–792.CrossRefPubMed
20.
Zurück zum Zitat Jackson, L. A., Benson, P., Sneller, V.-P., Butler, J. C., Thompson, R. S., Chen, R. T., et al. (1999). Safety of revaccination with pneumococcal polysaccharide vaccine. Journal of the American Medical Association,281(3), 243–248.CrossRefPubMed Jackson, L. A., Benson, P., Sneller, V.-P., Butler, J. C., Thompson, R. S., Chen, R. T., et al. (1999). Safety of revaccination with pneumococcal polysaccharide vaccine. Journal of the American Medical Association,281(3), 243–248.CrossRefPubMed
25.
Zurück zum Zitat Neumann, P. J., Sanders, G. D., Russell, L. B., Siegel, J. E., & Ganiats, T. G. (2017). Cost effectiveness in health and medicine (2nd ed.). New York: Oxford University Press. Neumann, P. J., Sanders, G. D., Russell, L. B., Siegel, J. E., & Ganiats, T. G. (2017). Cost effectiveness in health and medicine (2nd ed.). New York: Oxford University Press.
26.
Zurück zum Zitat Braithwaite, R. S., Meltzer, D. O., King, J. T. J., Leslie, D., & Roberts, M. S. (2008). What does the value of modern medicine say about the $50,000 per quality-adjusted life-year decision rule? Medical Care,46(4), 349–356.CrossRefPubMed Braithwaite, R. S., Meltzer, D. O., King, J. T. J., Leslie, D., & Roberts, M. S. (2008). What does the value of modern medicine say about the $50,000 per quality-adjusted life-year decision rule? Medical Care,46(4), 349–356.CrossRefPubMed
31.
Zurück zum Zitat Nowalk, M. P., Zimmerman, R. K., Lin, C. J., Raymund, M., Tabbarah, M., Wilson, S. A., et al. (2008). Raising adult vaccination rates over 4 years among radically diverse patients at inner-city health centers. Journal of the American Geriatrics Society,56, 1177–1182.CrossRefPubMed Nowalk, M. P., Zimmerman, R. K., Lin, C. J., Raymund, M., Tabbarah, M., Wilson, S. A., et al. (2008). Raising adult vaccination rates over 4 years among radically diverse patients at inner-city health centers. Journal of the American Geriatrics Society,56, 1177–1182.CrossRefPubMed
32.
Zurück zum Zitat Schwartz, K. L., Neale, A. V., Northrup, J., Monsur, J., Patel, D. A., Tobar, R., Jr., et al. (2006). Racial similarities in response to standardized offer of influenza vaccination. A MetroNet study. Journal of General Internal Medicine,21(4), 346–351.CrossRefPubMedPubMedCentral Schwartz, K. L., Neale, A. V., Northrup, J., Monsur, J., Patel, D. A., Tobar, R., Jr., et al. (2006). Racial similarities in response to standardized offer of influenza vaccination. A MetroNet study. Journal of General Internal Medicine,21(4), 346–351.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Anderson, W. L., Armour, B. S., Finkelstein, E. A., & Wiener, J. M. (2010). Estimates of state-level health-care expenditures associated with disability. Public Health Reports,125(1), 44–51.CrossRefPubMedPubMedCentral Anderson, W. L., Armour, B. S., Finkelstein, E. A., & Wiener, J. M. (2010). Estimates of state-level health-care expenditures associated with disability. Public Health Reports,125(1), 44–51.CrossRefPubMedPubMedCentral
Metadaten
Titel
Cost-Effectiveness of Pneumococcal Vaccination and Uptake Improvement Programs in Underserved and General Population Adults Aged < 65 Years
verfasst von
Angela R. Wateska
Mary Patricia Nowalk
Chyongchiou J. Lin
Lee H. Harrison
William Schaffner
Richard K. Zimmerman
Kenneth J. Smith
Publikationsdatum
10.08.2019
Verlag
Springer US
Erschienen in
Journal of Community Health / Ausgabe 1/2020
Print ISSN: 0094-5145
Elektronische ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-019-00716-8

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