OBJECTIVES: Half a million Danes 65+ are chronically ill. Aim was to estimate the potential impact on health- and social care of vaccination with Prevenar 13 against pneumococcal pneumonia (PP) in chronic disease patients 65+ in Denmark (2017-2020).

METHODS: Modelled analysis using pneumonia hospitalization data (2016) from the national patient registry. Chronic diseases included: chronic obstructive pulmonary disease, heart failure, diabetes, chronic kidney disease, chronic liver disease, chronic heart disease, asthma and chronic bronchitis. Hospitalizations are corrected for comorbidity. PP was estimated as 30% of all pneumonia cases with 41.4% of them containing Prevenar 13 serotypes. Vaccine efficacy (5-year duration) was 72.8% based on real-world effectiveness data. Analysis was adjusted for mortality and herd immunity effect (childrens vaccination). Costs of pneumonia came from a Danish registry study (Brogaard et al. 2015).

RESULTS: Results are shown below.

Parameters:

• 26,483 chronic disease patients with pneumonia hosp/year (Patient Registry)
• 37,765 pneumonia hospitalizations/year, incl. 42.6% re-hosp. (Danish Statistics)
• 30% PP share(Niederman et al. 2012)
• 4% Prevenar 13 serotypes (Benfield et al. 2013 & Said et al. 2013)
• 8% Vaccine efficacy (McLaughlin et al. 2018)
• 25% annual vaccine rate (Assumption)
• 5 year duration of vaccine efficacy (Bonten et al. 2015)
• 6% annual death rate in chronic ill patients (Death-cause registry)
• 26% herd immunity – annual effect from children NIP (Weinberger et al. 2018)

Results (2017-2024), incl. four vaccination years:

• 11,853 PP hospitalizations avoided (2017-2024) (Model calculation)
• 59,265 PP cases avoided, incl. 80% outpatient (Model calculation)
• 95 million Euros saved healthcare sector costs (4% discount rate) (Model calculation)
• 186 million Euros saved health- and social care costs(Model calculation)

CONCLUSIONS: The analysis shows that hypothetical vaccination of all chronic ill Danes 65+ with Prevenar 13 will potentially prevent 11,853 hospitalizations leading to substantial savings. Costs of vaccination not included.