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Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727


LORENTE ANTONANZAS, Reyes; VARONA MALUMBRES, Juan Luis; ANTONANZAS VILLAR, Fernando  and  REJAS GUTIERREZ, Javier. A Dynamic Model to Estimate the Budget Impact of a Pneumococcal Vaccination Program in a 65 Year-old immunocompetent Spanish Cohort with 13-Valent Pneumococcal Conjugate Vaccine. Rev. Esp. Salud Publica [online]. 2016, vol.90, e40001.  Epub Jan 18, 2016. ISSN 2173-9110.


Infections caused by Streptococcus pneumonie in adults have important health consequences. To estimate the 5-year clinical and economic impact of a pneumococcal vaccination program on immunocompetent population aged 65-year-old in Spain.


A 5 year dynamic model based on differential equations was built for the conceptualization of the burden of pneumococcal disease (PD) on a 65 year-old cohort. A 36.5% of the cohort was vaccinated with an expected efficacy rate of 52.5% as observed in the CAPITA study. The serotype vaccination coverage used was 63.4% (CAPA study), the incidence of pneumococcal disease was 162.2 per 100,000 cases per year (CMBD 2010-2013) and a rate of vaccinated subjects previously from the start of the model of 0.99%. The study used the perspective of The National Health System, and included the costs associated to PD and the conjugate vaccine laboratory selling price.


In a 5 years-period, the vaccination with 13-valent pneumococcal conjugate vaccine is expected to avoid 10,360 cases of pneumococcal disease (7,411 in-patient pneumonias) and 699 deaths (14,736 Life Years Gained) in the 65 year old cohort. Vaccination costs of 36.5 million euros would be completely offset by medical cost reduction of 41.5 million euros, yielding to a net saving of 3.8 million constant euros (4.9 million undiscounted).


PCV13 vaccination targeting the cohort of 65 year-old immunocompetent Spanish adults is expected to result in net savings for the National Health System, while decreasing disease burden and averting a substantial number of related deaths.

Keywords : Pneumococcal vaccines; Conjugate vaccine; Health expenditure; Burden of illness; Adults; Spain.

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