Pneumococcal vaccine. Efficacy and associated cost savings
C. B. Gable, S. S. Holzer, L. Engelhart, R. B. Friedman, F. Smeltz, D. Schroeder and K. Baum
Medical Technologies Assessment Division, SysteMetrics/McGraw-Hill, Washington, DC 20008.
We evaluated the efficacy and cost savings of the pneumococcal pneumonia
vaccine in a retrospective cohort study of 762 vaccinated and 1161 randomly
selected unvaccinated age-sex matched persons in Blue Cross/Blue Shield of
Minnesota using medical and pharmaceutical claims. The pneumonia incidence
and the ratio of incidence in the postvaccination to prevaccination periods
(rate ratio) were examined in the vaccine group by sex and risk factors.
Vaccination significantly reduced pneumonia incidence, with overall
efficacy of 69% and higher efficacy in women (86%) than in men (33%). We
assigned persons to risk categories based on disease conditions as recorded
in the claims by the ICD-9-CM (International Classification of Diseases,
Ninth Revision, Clinical Modification) diagnostic codes. In the risk
categories, efficacy varied from 50% to 75% and was confounded by sex.
Immunocompromised and immunocompetent women had high efficacy (83% to 88%),
while immunocompetent and immunocompromised men had lower efficacy (33%).
Persons with a precondition of pneumonia exhibited similar vaccine efficacy
to the overall cohort relative to the comparison group. Projected costs of
pneumonia cases are 3.6 times the observed costs of vaccination and
postvaccination pneumonia costs. We conclude that the pneumococcal
pneumonia vaccine is efficacious in persons having had pneumonia, persons
"at risk" of developing pneumonia, or persons over 50 years of age, and it
corresponds to overall savings of $141 per person.
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ABSTRACT
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ABSTRACT
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Weiss and Davis
Am J Epidemiol 2002;156:395-396.
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ABSTRACT
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ABSTRACT
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ABSTRACT
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ABSTRACT
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Med Decis Making 1996;16:99-107.
ABSTRACT
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ABSTRACT
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