Table 1. Model inputs.
| Distribution of population among adults aged 65 and older | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age | % | [10] | ||||||||||
| 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, | 6.9, 6.6, 4.1, 4.4, 5.3, 5.1, 5.2, 5.0, 4.5, 3.9, | |||||||||||
| 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, | 4.1, 4.2, 4.1, 3.8, 3.5, 3.4, 3.2, 3.0, 2.7, 2.5, | |||||||||||
| 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, | 2.3, 2.1, 1.9, 1.6, 1.3, 1.1, 0.9, 0.7, 0.6, 0.4, | |||||||||||
| 95, 96, 97, 98, 99,100+ | 0.3, 0.3, 0.2, 0.1, 0.1, 0.2 | |||||||||||
| Percentage of female among each age | ||||||||||||
| 51.4, 51.5, 51.9, 52.4,52.7, 52.9,53.2, 53.4, 53.8, 54.2, | ||||||||||||
| 54.8, 55.3,55.9,56.7,57.6, 58.6, 59.3, 60.4,61.5,62.8 | ||||||||||||
| 63.9, 65.4, 66.9, 69.2, 71.2 74.4, 76.3, 77.7, 78.4, 79.9 | ||||||||||||
| 81.1, 81.6, 83.6,84.1,84.8, 87.3 | ||||||||||||
| Rate and proportions a | 65+ | 65–69 | 70–74 | 75–79 | 80–84 | 85–89 | 90–94 | 95+ | ||||
| Annual incidence rate of IPD (per 100,000 population) | 2.4 | 1.8 | 1.8 | 2.5 | 2.7 | 4.2 | 4.4 | 4.2 | [10, 19] | |||
| Bacteremia without pneumococcal pneumonia among IPD cases (%) | 35.6 | 36.8 | 40.0 | 29.8 | 38.0 | 33.9 | 42.1 | 16.7 | [19] | |||
| Bacteremia with pneumococcal pneumonia among IPD cases (%) | 45.8 | 39.5 | 35.5 | 50.7 | 45.1 | 54.8 | 50.0 | 66.7 | [18] | |||
| Meningitis among IPD cases (%) | 18.6 | 23.6 | 24.5 | 19.6 | 16.8 | 11.3 | 7.9 | 16.7 | [19] | |||
| Annual incidence rate of CAP (per 1,000 population) | 10.7 (aged 65–74), 42.9 (age > = 75) | [21] | ||||||||||
| CAP caused by S. pneumoniae (%) | 17.2 | [20] | ||||||||||
| Bacteremia without pneumococcal pneumonia result in sequelae (%) | 2.0 | [22] | ||||||||||
| Bacteremia with pneumococcal pneumonia result in sequelae (%) | 7.0 | [22] | ||||||||||
| Meningitis result in sequelae (%) | 30.0 | [22] | ||||||||||
| Non-bacteremic pneumococcal pneumonia result in sequelae (%) | 2.7 | [22] | ||||||||||
| Case-fatality rate (%) | ||||||||||||
| Bacteremia without pneumococcal pneumonia | 25.0 | [22] | ||||||||||
| Bacteremia with pneumococcal pneumonia | 30.5 | [22] | ||||||||||
| Meningitis | 14.9 | [22] | ||||||||||
| Non-bacteremic pneumococcal pneumonia | 1.9 | [23] | ||||||||||
| Sequelae | 5.0 | [22] | ||||||||||
| Serotypes covering of disease caused by S. pneumococcus | ||||||||||||
| Invasive pneumococcal diseases | PPSV–23: 60.0% | PCV–13: 46.0% | [19] | |||||||||
| Non-bacteremic pneumococcal pneumonia | PPSV–23: 62.9% | PCV–13: 49.3% | [13] | |||||||||
| Utility weights | [25] | |||||||||||
| Health | 1 | |||||||||||
| Bacteremia without pneumococcal pneumonia | 0.5 | |||||||||||
| Bacteremia with pneumococcal pneumonia | 0.5 | |||||||||||
| Meningitis | 0.4 | |||||||||||
| Pneumococcal pneumonia | 0.5 | |||||||||||
| Sequelae | 0.3 | |||||||||||
| Death | 0 | |||||||||||
| Average lengths of hospital stay (day) | 65–69 | 70–74 | 75–79 | 80–84 | 85–89 | 90–94 | 95–99 | 100+ | ||||
| Bacteremia/pneumonia | 12.3 | 13.1 | 14.1 | 14.9 | 15.6 | 16.1 | 16.3 | 16.2 | [26] | |||
| Meningitis | 24.5 | 26.3 | 28.3 | 29.9 | 31.2 | 32.1 | 32.6 | 32.4 | [26] | |||
| Treatment costs per case (¥) | ||||||||||||
| Bacteremia/pneumonia | 428,005 | 440,028 | 453,172 | 453,404 | 449,147 | 435,079 | 425,829 | 408,372 | [26] | |||
| Meningitis | 856,011 | 880,057 | 906,343 | 906,808 | 898,293 | 870,158 | 851,658 | 816,744 | [26] | |||
| Sequelae (per case per year) | 1,500,000 | [27] | ||||||||||
| Costs per vaccination (¥) | ||||||||||||
| Cost per PPSV–23 shot | 8,116 | [28, 29] | ||||||||||
| Cost per PCV–13 shot | 10,776 | [28, 29] | ||||||||||
aOn Markov model, transition probabilities from health state A to health state B by ages were calculated as follows
From “Health” to “Bacteremia without pneumococcal pneumonia” = Annual incidence rate of IPD × Bacteremia without pneumococcal pneumonia among IPD cases
From “Health” to “Bacteremia with pneumococcal pneumonia” = Annual incidence rate of IPD × Bacteremia with pneumococcal pneumonia among IPD cases
From “Health” to “Meningitis” = Annual incidence rate of IPD × Meningitis among IPD cases
From “Health” to “Non-bacteremic pneumococcal pneumonia” = Annual incidence rate of CAP × CAP caused by S. pneumoniae