OBJECTIVES : Infection with Streptococcus-pneumoniae may cause noninvasive and invasive pneumococcal-disease (IPD). Globally, pneumococcal-disease is estimated to cause 2 million deaths annually. Vulnerable populations include adults aged ≥50 and at-risk with chronic disease, for whom a vaccination recommendation exists. In Austria around 32,000 adults suffer from pneumococcal-infections each year; 20,000 corresponding to PPV23 and/or PCV13-serotypes-about 330 develop IPD. The aim of the BIA is to compare the current situation of the pneumococcal vaccination-program, where a percentage of older and at-risk adults receive vaccination (PPV23 or PCV13) compared to no vaccination. The budget-impact quantifies the positive effect due to vaccination.

METHODS : A multi-cohort, population-based model was developed over a 5-year time-horizon, which included the following states: hospitalized and outpatient pneumococcal-diseases, IPD, associated complications and mortality. In the vaccination-arm a percentage of adults, corresponding to the market-share, (15% 1^st year to 20% 5^th year) are vaccinated. The model includes a serotype shift over time. Results showed the amount of savings form the health-care-systems and societal perspective. Vaccination costs are based on the pharmacy-selling-price, which is payed out-of-pocket.

RESULTS : Based on the current vaccination coverage annual savings between 3.7 million € (m€) (1^st year) and 4.8 m€ (5^th year) [total: 21.6 m€ over 5 years] could be achieved. Direct costs contributed between 2.8 m€ (1^st year) and 3.6 m€ (5^th year) [total: 16.0 m€] to total annual savings. Financial benefits to society can be achieved by a responsible vaccination strategy. The savings in indirect costs range from 1.0 m€ (1^st year) to 1.2 m€ (5^th year) [total: 5.5 m€]. The costs of the vaccination are borne by the patients, who make private payments between 2.6 m€ (1^st year) and 2.7 m€ (5^th year) per year [total: 13.5 m€].

CONCLUSIONS : In Austria, 1€ privately invested in pneumococcal vaccination has a 1.60€ return to society and saves the health-care-system 1.19€.