Abstract
The aim. To evaluate the economic efficiency and the choice of the vaccination strategy in the respiratory pneumococcal infection risk groups among the adult population of the Astrakhan region.Materials and methods. The data for the period of 2015 - 2018 were analyzed on the number of registered diseases in the patients living in the service area of the medical organizations (Form No. 12, Federal State Statistics Service Orders No. 591, dated 27 November, 2015; No. 679, dated 22 November, 2019). The following working directives were studied: the base medical examination documentation submitted by medical institutions (Form No. 030/y “Dispensary Monitoring Checklist”; lists of the persons subjected to medical observation in the reporting year; Orders of the Ministry of Health of the Russian Federation: No. 1344, dated 12 December, 2012; No. 173n, dated 29 March, 2019). Statistical materials of the territorial fund for compulsory medical insurance of the Astrakhan region on the payment of medical care to 12,970 patients who had had pneumonia in 2015-2018, were analyzed. The financial support of vaccination based on the results of tenders for the procurement of pneumococcal vaccines organized by the regional Ministry of Health, was considered. The calculations were carried out in accordance with the guidelines of “Cost-effectiveness of vaccine prophylaxis” (Methodological guidelines 3.3.1878-04, dated 04.03.2004).Results. The prospective calculation of the vaccination cost showed that the benefits of vaccination with pneumococcal conjugate vaccine Prevenar13 (PCV13) and pneumococcal polyvalent vaccine Pneumovax 23 (PPV23) with a 95% vaccination coverage, are recorded after 2 years. The economic benefit of vaccination by reducing the possible number of pneumonias at the end of 2028 will be 968.2 million rubles.Conclusion. The economic feasibility of vaccine prophylaxis of the adult contingent with an increased risk of developing pneumococcal infection has been established. The sequential strategy of PCV13 and PPV23 application provides the most effective localization of pneumococcal infection. The research results should be widely introduced into the long-term plans for vaccination and healthcare practice in the Astrakhan region.
Highlights
Community-acquired pneumonia (CAP) has a leading position in the structure of morbidity and mortality from infectious diseases in the world
In terms of treatment costs, community-acquired pneumonia leads to significant economic losses suffered by the state
There are 3.9 cases of this disease in 1000 people per year among people over 18 years of age in Russia [1, 2]. These indicators do not reflect the true prevalence of CAP in Russia
Summary
Community-acquired pneumonia (CAP) has a leading position in the structure of morbidity and mortality from infectious diseases in the world. There are 3.9 cases of this disease in 1000 people per year among people over 18 years of age in Russia [1, 2]. These indicators do not reflect the true prevalence of CAP in Russia. In comparison with somatically healthy individuals, the risk of PI developing is 13.3 times higher in oncohematological patients, 9.8 times higher in chronic obstructive pulmonary disease (COPD), 6.5 times higher in HIV infection, and 5.8 times higher in immunosuppressive conditions and chronic liver diseases.
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