POSC103 Pneumococcal Vaccination with 13-Valent Polysaccharide Conjugate Vaccine for Older Adults with Chronic Conditions: Budget Impact Analysis in Colombia

Abstract

To determine the budget impact analysis of pneumococcal vaccination with 13-valent polysaccharide conjugate vaccine (PCV13) in adults 60 years of age and older with chronic conditions in Colombia A decision tree was developed comparing vaccinated adults 60 years of age and older with chronic risk conditions for pneumococcal diseases with no vaccination. The age-specific annual rates for outpatient and inpatient pneumonia, meningitis, bacteremia caused by Streptococcus pneumoniae were extracted from the literature for patients with chronic obstructive pulmonary diseases (COPD), diabetes, cardiovascular diseases, and cancer. The frequency of the medical conditions considering of the model was based on the national report. The effectiveness of PCV13 were estimated from the clinical trial in adults 65 years of age or older. The health care resources of the events were obtained for published national studies and the cost of vaccine dose was estimated from national database. Time horizon in the analysis was 10 years. Subgroup analysis was conducted for relevant risk group. The cost and events were discount with annual rate of 3%. The exchange rate used was 3.600 Colombian pesos/1 USD. Simulating a cohort of 25.000 patients, PCV13 prevent 185 cases of inpatient pneumonia, 3 cases of outpatient pneumonia, 118 cases of invasive pneumococcal diseases and 41 deaths compared to no vaccination. The savings associated to medical care would be 771.114 USD characterized mainly by inpatient pneumonia and bacteremia. The vaccination cost may vary 500.000 and 875.000 USD. The net savings would be 83.614 USD which can vary according to the price of the vaccine. The highest return on investment is were obtained in COPD patients due to the high risk of invasive pneumococcal disease and pneumonia. PCV13 immunization is most likely to lead substantial cost savings in the following 10 years after vaccination with high impact in the public health.