Cost-Effectiveness of Pneumococcal Vaccination among Patients with Diabetes Mellitus
https://doi.org/10.31631/2073-3046-2022-21-5-78-88
Abstract
Relevance. Patients with diabetes mellitus have an increased risk of developing various infections, including those of the lower respiratory tract. Immunization with anti-pneumococcal vaccines reduces pneumonia-related hospitalizations and deaths.
Aim. Evaluate the cost-effectiveness of vaccination against pneumococcal infection in 40and 65-year-old patients with type 2 diabetes mellitus (DM2).
Material and methods. The analysis was carried out from the perspective of the healthcare system. The Markov model based on Russian epidemiological data, taking into account the results of foreign studies, was used. Vaccination schedules with 1 dose of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 1 dose of pneumococcal 23-valent polysaccharide vaccine (PPV23) and vaccination with only 1 dose of PCV13 were evaluated. The time horizon of the study is 5 years. Costs and life expectancy were discounted by 3.5% per year.
Results. Vaccination of 65-year-old patients with type 2 diabetes is characterized by extremely high cost-effectiveness (the incremental cost effectiveness ratio – ICER – for PCV13+PPV23 vaccination is 189.27 thousand rubles/QALY, and PCV13 vaccination entails a cost reduction of 371.92 rubles per 1 vaccinated). When vaccinating 40-year-old patients, the ICER for PCV13 + PPV23 vaccination is 491.31 thousand rubles/QALY, and for PCV13 – 55.31 thousand rubles/QALY.
Conclusion. Vaccination against pneumococcal disease in 40and 65-year-old patients with DM2 reduces the associated morbidity and mortality and is highly cost-effective. Compared to PCV13 vaccination alone, vaccination with PCV13 followed by the introduction of PPV23 provides an increase in the number of prevented cases of the disease and the deaths caused by it, but at the same time requires additional costs.
About the Authors
A. V. RudakovaRussian Federation
Alla V. Rudakova – Dr. Sci. (Pharm), Professor, Senior researcher of Department of the organization of medical care in the Federal State-Financed Institution Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency, Professor of Department of Management and Economics of Pharmacy, St. Petersburg Chemical and Pharmaceutical University
Saint Petersburg
N. I. Briko
Russian Federation
Nikolai I. Briko – the RAS Academician, Dr. Sci. (Med), Professor, Director of the Institute of Public Health F. F. Erisman; Head of Epidemiology and Evidence Based Medicine Department in the I.M. Sechenov First Moscow State Medical University (Sechenov University); Chief External Epidemiologist of the Ministry of Health of the Russian Federation
Moscow
Yu. V. Lobzin
Russian Federation
Yury V. Lobzin – the RAS Academician, Dr. Sci. (Med), Professor, President of the Federal State-Financed Institution Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency; Head of the Department of Infectious Diseases of the North-Western State Medical University named after I. I. Mechnikov, Chief External Specialist in Infectious Diseases in Children of the Ministry of Health of the Russian Federation
Saint Petersburg
I. S. Namazova-Baranova
Russian Federation
Leila S. Namazova-Baranova – the RAS Academician, Dr. Sci. (Med), Professor. Head of the Department of Faculty Pediatrics in Pediatric Department of the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Head of the Research Institute of Pediatrics and Children’s Health in the Central Clinical Hospital of the RAS; Chief External pediatric specialist in preventive medicine of the Ministry of Health of the Russian Federation
Moscow
S. N. Avdeev
Russian Federation
Sergey N. Avdeev – the RAS Academician, Dr. Sci. (Med), Professor, Head of the Department of Pulmonology in the I.M. Sechenov First Moscow State Medical University (Sechenov University); Head of the Clinical Department of the Federal State Budgetary Institution «Research Institute of Pulmonology» of the Federal Medical and Biological Agency of Russia, Chief External Pulmonologist of the Ministry of Health of the Russian Federation
Moscow
V. A. Korshunov
Russian Federation
Vladimir A. Korshunov – Cand. Sci. (Med), Аssociate Professor of Epidemiology and Evidence Based Medicine Department
Moscow
M. P. Kostinov
Russian Federation
Mikhail P. Kostinov – the RAS corresponding member, Dr. Sci. (Med), Professor, Head of the Laboratory of Vaccine Prevention and Immunotherapy of Allergic Diseases in Research Institute of Vaccines and Serums named after I. I. Mechnikov, Professor of the Department of Epidemiology in the I.M. Sechenov First Moscow State Medical University (Sechenov University)
Moscow
G. I. Ignatova
Russian Federation
Galina L. Ignatova – Dr. Sci. (Med), Professor. Head of the Department of Therapy, Institute of Additional Professional Education
Chelyabinsk
E. V. Blinova
Russian Federation
Elena V. Blinova – Cand. Sci. (Med), Associate professor in Department of Therapy, Institute of Additional Professional Education
Chelyabinsk
A. V. Kontsevaya
Russian Federation
Anna V. Kontsevaya – Dr. Sci. (Med), Deputy Director for Research and Analytical Work
Moscow
R. V. Shepel
Russian Federation
Ruslan N. Shepel – Cand. Sci. (Med), Deputy Director for promising areas of medical activity, Federal State Budgetary Institution «National Medical Research Center for Preventive Medicine» of the Ministry of Health of Russia, Chief External therapist of the Central Federal District
Moscow
I. Yu. Drozdova
Russian Federation
Lyubov Yu. Drozdova – Cand. Sci. (Med), Head of the outpatient therapy laboratory of the Federal State Budgetary Institution «National Medical Research Center for Preventive Medicine» of the Ministry of Health of Russia, Chief External Specialist in Medical Prevention of the Ministry of Health of Russia
Moscow
O. M. Drapkina
Russian Federation
Oksana M. Drapkina – the RAS Academician, Dr. Sci. (Med), Professor, Director of the Federal State Budgetary Institution «National Medical Research Center for Preventive Medicine» of the Ministry of Health of Russia, Chief External Therapist of the Ministry of Health of Russia
Moscow
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Review
For citations:
Rudakova A.V., Briko N.I., Lobzin Yu.V., Namazova-Baranova I.S., Avdeev S.N., Korshunov V.A., Kostinov M.P., Ignatova G.I., Blinova E.V., Kontsevaya A.V., Shepel R.V., Drozdova I.Yu., Drapkina O.M. Cost-Effectiveness of Pneumococcal Vaccination among Patients with Diabetes Mellitus. Epidemiology and Vaccinal Prevention. 2022;21(5):78-88. (In Russ.) https://doi.org/10.31631/2073-3046-2022-21-5-78-88