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Academia and the Profession |

Cost Effectiveness of Vaccination Against Pneumococcal Pneumonia: An Update

JANE E. SISK, Ph.D.; and RICHARD K. RIEGELMAN, M.D., Ph.D.
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▸Requests for reprints should be addressed to Jane E. Sisk, Ph.D.; Health Program, Office of Technology Assessment; U.S. Congress, Washington, D.C. 20510.


Washington, D.C.


Ann Intern Med. 1986;104(1):79-86. doi:10.7326/0003-4819-104-1-79
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We updated a 1978 cost-effectiveness analysis of vaccination against pneumococcal pneumonia in light of the introduction in 1983 of a 23-valent vaccine, recent medical literature, and different relative prices of medical services. Although other base-case assumptions have remained reasonable, the low estimates of 10% of pneumonia as pneumococcal and a 3-year duration of immunity now appear more likely. Vaccination of a person age 65 or older could gain a year of healthy life for about $6000 in 1983 dollars. Medicare has covered pneumococcal vaccination since 1981. With the revised assumptions, net Medicare expenditures ranged from about $5.50 to $10.50 per vaccination, or from $4400 to $8300 per year of healthy life gained. Vaccination of an elderly person would almost break even, if duration of immunity were 8 years and would be cost saving if the vaccine were administered under a public program. Current levels of vaccination appear too low considering the potential health benefits and cost-effectiveness.

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