COST-EFFECTIVENESS OF VACCINATION AGAINST PNEUMOCOCCAL PNEUMONIA IN THE NETHERLANDS

Because of the prevalence of pneumococcal pneumonia and the substantia l morbidity and mortality associated with many pneumococcal infections , considerable efforts have been made in disease prevention, using a p olyvalent polysaccharide pneumococcal vaccine. Although the WHO has en dorsed a policy df universal vaccination of all elderly people, the ec onomic aspects of such a policy have not been determined. Using a deci sion tree framework, this paper examines the cost effectiveness of Var ious strategies of pneumococcal vaccination for the elderly in The Net herlands. For Various age categories, the economic attractiveness of t he vaccination of ail individuals as well as the Vaccination of only t hose individuals with a specific disease has been calculated. We concl ude that, allowing for some uncertainty regarding key variables such a s the Vaccine efficacy and the hospital admission rate, the vaccinatio n of all individuals above the age of 65 years is comparable in terms of cost-effectiveness to many existing health care interventions. The vaccination of individuals above the age of 55 years with chronic lung disease or chronic heart disease is similarly attractive from an econ omic point of view, as is the vaccination of individuals above the age of 65 years with diabetes mellitus.