Cost-effectiveness analysis of pneumococcal vaccination in the elderly Spanish population

The high morbidity and mortality associated with pneumococcal pneumonia in subjects over 60 years old, the emergence of bacterial strains resistant to standard antimicrobial therapy and the availability of an anti-pneumococcal vaccine suggest the need to perform an economic study to evaluate the suitability of vaccination as a preventive strategy in those aged 60 years and over in Spain. The introduction of the Vaccination programme would cost US$ 97,593,663. Over the subsequent five years - with a basal rate of three pneumococcal pneumonias per 1000 person-years and a 66% vaccine efficacy - the programme would result in a net benefit of US$ 127,142,481, a benefit/cost ratio of 2.30 and a benefit per case prevented of US$ 2,656. Benefit/cost ratios above 1 would be obtained for incidences above 1.5 cases per 1000 person-years. Introduction of a universal vaccination programme in those over 60 years of age in Spain would be cost-effective over a wide range of incidence rates of pneumococcal pneumonia.