Cost-Effectiveness of the Pneumococcal Vaccine in Healthy Younger Adults

2002 ◽  
Vol 22 (1_suppl) ◽  
pp. 45-57 ◽  
Author(s):  
Patricia Vold Pepper ◽  
Douglas K. Owens
Keyword(s):  
Young Adults ◽  
Cost Effectiveness ◽  
Pneumococcal Vaccine ◽  
Adult Population ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Incidence Rates ◽  
Younger Adults ◽  
Effective Measure ◽  
The Cost

Objectives Routine vaccination for Streptococcus pneumoniae has been recommended as a cost-effective measure for elderly and immunocompromised patients, yet no analysis has been performed for healthy younger adults in America. The authors evaluated the cost-effectiveness of the pneumococcal vaccine and determined the net health benefits conferred for the healthy young adult population. Methods The authors developed a decision model to compare the health and economic outcomes of vaccinate versus do not vaccinate for S. pneumoniae. Results Vaccinating patients for S. pneumoniae generates benefits that are dependent on incidence rates and the efficacy of the vaccine. In the 22-year-old patient with a pneumonia incidence of 0.3/1000, the vaccine would need to be >71 percent effective for the vaccination strategy to cost less than $50,000/QALY gained. At an incidence of 0.4/1000, the threshold efficacy is 53 percent, whereas at 0.5/1000 it is 43 percent. In the 35-year-old patient where the incidence of pneumococcal pneumonia is higher (0.85/1000), the vaccine would be cost-effective with an efficacy as low as 30 percent. Conclusions Use of the S. pneumoniae vaccine in young adults would provide modest reductions in pneumonia-associated morbidity and mortality. Vaccination of young adults is moderately expensive unless vaccine efficacy is above 50% to 60%. In 35-year-old adults, use of the vaccine is cost-effective even with moderate efficacy.

scholarly journals THE COST-EFFECTIVENESS OF DEPRESSION SCREENING FOR THE GENERAL ADULT POPULATION

2021 ◽  
Author(s):  
Melike Yildirim ◽  
Bradley Gaynes ◽  
Pinar Keskinocak ◽  
Brian Pence ◽  
Julie L Swann
Keyword(s):  
Cost Effectiveness ◽  
Transition Probabilities ◽  
Adult Population ◽  
Cost Effective ◽  
Routine Screening ◽  
Screening Tools ◽  
Male Population ◽  
Life Years ◽  
Annual Screening ◽  
The Cost

Objective. Screening has an essential role in preventive medicine. Ideally, screening tools detect patients early enough to manage the disease and reduce symptoms. We aimed to determine the cost-effectiveness of routine screening schedules. Methods. We used a discrete-time nonstationary Markov model to simulate the progression of depression. We adopted annual transition probabilities, which were dependent on patient histories, such as the number of previous episodes, treatment status, and time spent without treatment state based on the available data. We used Monte Carlo techniques to simulate the stochastic model for 20 years or during the lifetime of individuals. Baseline and screening scenario models with screening frequencies of annual, 2-year, and 5-year were compared based on incremental cost-effectiveness ratios (ICER). Results. In the general population, all screening strategies were cost-effective compared to the baseline. However, male and female populations differed based on cost over quality-adjusted life years (QALY). Females had lower ICERs, and annual screening had the highest ICER for females, with 11,134 $/QALY gained. In contrast, males had around three times higher ICER, with annual screening costs of 34,065$/QALY gained. Conclusions. Considering the high lifetime prevalence and recurrence rates of depression, detection and prevention efforts can be one critical cornerstone to support required care. Our analysis combined the expected benefits and costs of screening and assessed the effectiveness of screening scenarios. We conclude that routine screening is cost-effective for all age groups of females and young, middle-aged males. Male population results are sensitive to the higher costs of screening.

scholarly journals Comparison of Primary and Secondary Prophylaxis Using PEGylated Recombinant Human Granulocyte–Stimulating Factor as a Cost-Effective Measure in Malignant Neoplasms: A Multicenter Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Qiuji Wu ◽  
Qiu Li ◽  
Jun Zhang ◽  
Zhumei Luo ◽  
Jin Zhou ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Febrile Neutropenia ◽  
Cost Effective ◽  
Secondary Prophylaxis ◽  
Sensitivity Analyses ◽  
Malignant Neoplasms ◽  
Effective Measure ◽  
Life Years ◽  
The Cost ◽  
Stimulating Factor

Purpose: The aim of the study was to evaluate the cost-effectiveness of PEGylated recombinant human granulocyte–stimulating factor (PEG-rhG-CSF) as a means of achieving primary and secondary prophylaxis against chemotherapy-induced neutropenia cancer cases.Methods: Individuals who underwent PEG-rhG-CSF therapeutics were monitored for 12 months, together with thorough examination of individual medical records for extracting medical care costs. Both prophylaxis-based therapeutic options (primary/secondary) were scrutinized for cost-effectiveness, using a decision-making analysis model which derived the perspective of Chinese payers. One-way and probabilistic sensitivity analyses were used to assess the robustness of the model.Results: In summary, 130 clinical cases treated using PEG-rhG-CSF prophylaxis were included in this study: 51 within the primary prophylaxis (PP) group and 79 within the secondary prophylaxis (SP) group. Compared with SP, PP-based PEG-rhG-CSF successfully contributed to a 14.3% reduction in febrile neutropenia. In general, PP was estimated to reduce costs by $4,701.81 in comparison to SP, with a gain of 0.02 quality-adjusted life years (QALYs). Equivalent results were found in differing febrile neutropenia (FN) risk subgroups. Sensitivity analyses found the model outputs to be most affected for the average time of hospitalization and for the cost of FN.Conclusion: From the perspective of Chinese payers, PP with PEG-rhG-CSF should be considered cost-effective compared to SP strategies in patients who received chemotherapy regimens with a middle- to high-risk of FN.

scholarly journals Piemonte

2012 ◽  
Vol 13 (2S) ◽  
pp. 52-54
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In Piemonte region 82% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 33 cases of cervicocarcinoma and 15 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,974 €/QALY).

scholarly journals Sardegna

2012 ◽  
Vol 13 (2S) ◽  
pp. 58-60
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In Sardegna region 75% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 17 cases of cervicocarcinoma and 8 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (10,841 €/QALY).

scholarly journals Trento

2012 ◽  
Vol 13 (2S) ◽  
pp. 67-69
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In the province of Trento 80% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 5 cases of cervicocarcinoma and 2 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,029 €/QALY).

scholarly journals Valle d’Aosta

2012 ◽  
Vol 13 (2S) ◽  
pp. 73-75
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In Valle d’Aosta region 89% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 1 case of cervicocarcinoma more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,365 €/QALY).

scholarly journals Liguria

2012 ◽  
Vol 13 (2S) ◽  
pp. 40-42
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In Liguria region 80% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 11 cases of cervicocarcinoma and 5 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,122 €/QALY).

scholarly journals Angiotensin II for the treatment of distributive shock in the intensive care unit: A US cost-effectiveness analysis

2020 ◽  
Vol 36 (2) ◽  
pp. 145-151
Author(s):  
Laurence W. Busse ◽  
Gina Nicholson ◽  
Robert J. Nordyke ◽  
Cho-Han Lee ◽  
Feng Zeng ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Angiotensin Ii ◽  
Adult Population ◽  
Survival Rates ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Life Years ◽  
The Us ◽  
Distributive Shock ◽  
The Cost

BackgroundPatients with distributive shock who are unresponsive to traditional vasopressors are commonly considered to have severe distributive shock and are at high mortality risk. Here, we assess the cost-effectiveness of adding angiotensin II to the standard of care (SOC) for severe distributive shock in the US critical care setting from a US payer perspective.MethodsShort-term mortality outcomes were based on 28-day survival rates from the ATHOS-3 study. Long-term outcomes were extrapolated to lifetime survival using individually estimated life expectancies for survivors. Resource use and adverse event costs were drawn from the published literature. Health outcomes evaluated were lives saved, life-years gained, and quality-adjusted life-years (QALYs) gained using utility estimates for the US adult population weighted for sepsis mortality. Deterministic and probabilistic sensitivity analyses assessed uncertainty around results. We analyzed patients with severe distributive shock from the ATHOS-3 clinical trial.ResultsThe addition of angiotensin II to the SOC saved .08 lives at Day 28 compared to SOC alone. The cost per life saved was estimated to be $108,884. The addition of angiotensin II to the SOC was projected to result in a gain of .96 life-years and .66 QALYs. This resulted in an incremental cost-effectiveness ratio of $12,843 per QALY. The probability of angiotensin II being cost-effective at a threshold of $50,000 per QALY was 86 percent.ConclusionsFor treatment of severe distributive shock, angiotensin II is cost-effective at acceptable thresholds.

scholarly journals Bolzano

2012 ◽  
Vol 13 (2S) ◽  
pp. 22-24
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In the province of Bolzano 86% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 4 cases of cervicocarcinoma and 2 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,035 €/QALY).

scholarly journals Calabria

2012 ◽  
Vol 13 (2S) ◽  
pp. 25-27
Author(s):  
Roberto Gasparini ◽  
Donatella Panatto ◽  
Bruna Dirodi ◽  
Rosa Prato ◽  
Gianni Amunni ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Protective Activity ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Quadrivalent Vaccines

In Calabria region 56% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 37 cases of cervicocarcinoma and 17 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (9,767 €/QALY).

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