Table 9. Cost-effectiveness analysis results.
| Cost | Incremental Cost |
Effectiveness (QALY) |
Incremental Effectiveness (QALY) |
ICER ($/QALY) |
|
|---|---|---|---|---|---|
| Base case | |||||
| No vaccination | $1,047 | - | 12.58345 | - | - |
| 65 and HR younger (PPSV23)* | $1,059 | $12 | 12.58380 | 0.00035 | (Ext Dom) |
| 65 and HR younger (PCV13) | $1,080 | $33 | 12.58461 | 0.00116 | $28,900 |
| PCV13 at 50, PPSV23 at 65 | $1,119 | $39 | 12.58449 | −0.00012 | (Dominated) |
| PCV13 at 50 65 | $1,123 | $43 | 12.58555 | 0.00094 | $45,100 |
| PCV13 at 50 65, PPSV23 at 75 | $1,131 | $8 | 12.58557 | 0.00002 | $496,000 |
| Worst case † | |||||
| No vaccination | $1,047 | - | 12.58345 | - | - |
| 65 and HR younger (PPSV23)* | $1,059 | $12 | 12.58380 | 0.00035 | $34,616 |
| 65 and HR younger (PCV13) | $1,092 | $34 | 12.58405 | 0.00027 | $131,486 |
| PCV13 at 50, PPSV23 at 65 | $1,127 | $35 | 12.58402 | -0.00003 | (Dominated) |
| PCV13 at 50 65 | $1,150 | $58 | 12.58428 | 0.00023 | $255,285 |
| PCV13 at 50 65, PPSV23 at 75 | $1,158 | $8 | 12.58430 | 0.00002 | $496,538 |
*
The currently recommended adult pneumococcal vaccination strategy
†
Lowest PCV13 effectiveness estimates against nonbacteremic pneumococcal pneumonia
PCV13 = 13-valent pneumococcal conjugate vaccination; PPSV = 23-valent pneumococcal polysaccharide vaccine; QALY = quality adjusted life year; ICER = incremental cost-effectiveness ratio; HR=high risk conditions
Ext Dom = extended dominance (other strategies have lower cost-effectiveness ratios than this strategy) Dominated = other strategies are less costly and more effective than this strategy. Based on recommendations, strategies that are dominated by either mechanism are eliminated from further consideration in a cost-effectiveness analysis.