Cost-effectiveness of pneumococcal vaccination of older people: A study in5 western European countries

Pneumococcal vaccination of older persons is thought to be cost-effective i n preventing pneumococcal pneumonia, but evidence of clinical protection is uncertain. Because there is better evidence of vaccination effectiveness a gainst invasive pneumococcal disease, we determined the cost-effectiveness of pneumococcal vaccination of persons aged greater than or equal to 65 yea rs in preventing hospital admission for both invasive pneumococcal disease and pneumococcal pneumonia in 5 western European countries. In the base cas e analyses, the cost-effectiveness ratios for preventing invasive disease v aried from similar to 11,000 to similar to 33,000 European currency units ( ecu) per quality-adjusted life year (QALY). Assuming a common incidence (50 cases per 100,000) and mortality rate (20%-40%) for invasive disease, the cost-effectiveness ratios were <12,000 ecu per QALY in all 5 countries. For preventing pneumococcal pneumonia, vaccinating all elderly persons would b e highly cost-effective to cost saving. Public health authorities should co nsider policies for encouraging pneumococcal vaccination for all persons ag ed greater than or equal to 65 years.