Cost-Effectiveness of Pneumococcal Vaccine for People 50 through 64 Years of Age

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The summary below is from the full report titled "Cost-Effectiveness of Vaccination against Invasive Pneumococcal Disease among People 50 through 64 Years of Age: Role of Comorbid Conditions and Race." It is in the 17 June 2003 issue of Annals of Internal Medicine (volume 138, pages 960-968). The authors are J.E. Sisk, W. Whang, J.C. Butler, V.-P. Sneller, and C.G. Whitney.

What is the problem and what is known about it so far?

Vaccines protect against infectious diseases. In the United States, doctors recommend some vaccines (such as polio and measles vaccines) for everyone and other vaccines (such as flu or Lyme disease vaccines) only for groups of people who are likely to get the disease or to become seriously ill if they do get the disease. One such vaccine is pneumococcal vaccine. Pneumococcus is a bacterium that can cause infection in the blood, lungs, and other places in the body. Older people and people with certain chronic medical conditions, such as asthma or diabetes, are particularly likely to develop serious problems if they get pneumococcal infections. Current recommendations in the United States are to give pneumococcal vaccine to people 65 years of age and older or to younger people with chronic medical conditions. However, some expert committees have considered lowering the recommended age for pneumococcal vaccine to 50 years. Whether the costs of giving pneumococcal vaccine to people 50 through 64 years of age are worth the potential health benefits is unknown.

Why did the researchers do this particular study?

To weigh the costs and health benefits of giving pneumococcal vaccine to people 50 through 64 years of age.

Who was studied?

Rather than studying actual patients, the researchers used computers to simulate a "virtual" group of 50- through 64-year-old Americans.

How was the study done?

Using published information, the researchers estimated what might happen if 50- through 64-year-olds did (or did not) get pneumococcal vaccine. They put this information into a computer model. The computer calculated how much it would cost for each year of life saved by avoiding invasive pneumococcal infection. The calculations accounted for the quality of life, as well as the years of life saved. The computer model also looked separately at "high-risk" people who had certain chronic medical conditions and "low-risk" people who did not have these conditions.

What did the researchers find?

The researchers' computer model suggested that giving pneumococcal vaccine to high-risk people actually saves total medical costs. Vaccinating low-risk groups cost between $2477 and $8195 per healthy year of life gained, a level of cost that our society usually finds acceptable.

What were the limitations of the study?

This study was a computer simulation, so we cannot be sure what the results would be with actual people.

What are the implications of the study?

Giving pneumococcal vaccine to people 50 through 64 years of age and older seems to be a reasonable health care practice when the costs and benefits are considered.