OBJECTIVES:

Streptococcus pneumoniae is the leading cause of community-acquired pneumonia (CAP). The incidence of pneumococcal-pneumonia (PP) is greatest at the extremes of age and with comorbidity. The incidence of CAP is estimated at 10.1/1000 inhabitants. In Austria 32,307 hospitalized CAPs were documented in adults; 31% (10,015) with S.Pneumoniae and 65% (6,510) of it corresponds PCV13-serotypes. 44% (2,864 VT CAPs) are attributable to COPD patients. 110 cases develop an invasive PP. The aim of the BIA is to quantify the monetary impact of an increased proportion of PCV13 vaccinated person’s in the different risk-groups (GOLDII+and GOLDIII+ in different age-groups) compared to a constant situation.

METHODS:

A multi-cohort, COPD population-based model was developed over a 5-year time-horizon, which includes the following states: hospitalized and outpatient CAPs, invasive-pneumococcal-diseases (IPDs), exacerbations and mortality. Patients without immunization are considered for PCV13 vaccination according to the selected vaccination-rates. A repetition-vaccination is considered. The model includes a serotype shift over time. Results show within which risk-groups savings could be achieved (treatment costs avoided offset PCV13 cost) and within which risk-groups additional health expenditure were generated from the payer’s perspective.

RESULTS:

Among risk-groups with COPD GOLDIII+ vaccination leads in all age-groups (≥18, ≥50, ≥60, ≥65) to cost-savings over 5-years (from 16.3 million € [≥18] to 23 million € [≥50]). Calculations are based on the present pharmacy-selling-price, which is payed out-of-pocket. Between 1,923-1,075 CAPs and 110-156 IPDs could be avoided over 5-years. Among risk-groups with COPD GOLDII+ reimbursement would increase health-expenditure between 15.2 million € (≥18) and 3.9 million € (≥50); between 2,747-1,565 CAPs and 135-229 IPDs could be avoided. In GOLDII+ age-groups a PCV13 reimbursement-(break-even)-price between 53-66€ would result in a 0 effect to health-care budgets.

CONCLUSIONS:

An increase of immunized persons – due to the incentive of reimbursement – would reduce disease-burden significantly and lead among high-risk patients to huge savings.