Title | Cost-effectiveness of Pneumococcal Vaccination Among Patients With CKD in the United States. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Ishigami J, Padula WV, Grams ME, Chang AR, Jaar B, Gansevoort RT, Bridges JFP, Kovesdy CP, Uchida S, Coresh JJ |
Secondary Authors | Matsushita K |
Journal | Am J Kidney Dis |
Volume | 74 |
Issue | 1 |
Pagination | 23-35 |
Date Published | 2019 07 |
ISSN | 1523-6838 |
Keywords | Aged, Cost-Benefit Analysis, Female, Glomerular Filtration Rate, Humans, Kidney Function Tests, Male, Middle Aged, Pneumococcal Vaccines, Pneumonia, Pneumococcal, Prevalence, Quality-Adjusted Life Years, Renal Insufficiency, Chronic, United States, Vaccination |
Abstract | RATIONALE & OBJECTIVE: Pneumococcal vaccine is recommended for adults 65 years and older and those younger than 65 years with clinical indications (eg, diabetes, lung/heart disease, kidney failure, and nephrotic syndrome). Its cost-effectiveness in less severe chronic kidney disease (CKD) is uncharacterized. STUDY DESIGN: Cost-effectiveness analysis. SETTING & POPULATION: US adults aged 50 to 64 and 65 to 79 years stratified by CKD risk status: no CKD (estimated glomerular filtration rateā„60mL/min/1.73m and urinary albumin-creatinine ratio INTERVENTION(S): Vaccination compared to no vaccination. OUTCOMES: Incremental cost-effectiveness ratios based on US dollars per quality-adjusted life-year (QALY). MODEL, PERSPECTIVE, & TIMEFRAME: Markov model, US health sector perspective, and lifetime horizon. RESULTS: The prevalence of pneumococcal vaccination in NHANES 1999 to 2004 was 56.6% (aged 65-79 years), 28.5% (aged 50-64 years with an indication), and 9.7% (aged 50-64 years without an indication), with similar prevalences across CKD risk status. Pneumococcal vaccination was overall cost-effective ( LIMITATIONS: Some model parameters were based on data from the general population. Analysis did not consider costs associated with kidney disease progression. CONCLUSIONS: Uptake of pneumococcal vaccination should be improved in general. Our results also suggest the cost-effectiveness of expanding its indication to younger adults with CKD less severe than kidney failure or nephrotic syndrome. |
DOI | 10.1053/j.ajkd.2019.01.025 |
Alternate Journal | Am J Kidney Dis |
PubMed ID | 30898360 |
Grant List | K23 DK106515 / DK / NIDDK NIH HHS / United States T32 HL007024 / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States HHSN268201100012C / HL / NHLBI NIH HHS / United States |