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Cost-effectiveness of Pneumococcal Vaccination Among Patients With CKD in the United States.

TitleCost-effectiveness of Pneumococcal Vaccination Among Patients With CKD in the United States.
Publication TypeJournal Article
Year of Publication2019
AuthorsIshigami J, Padula WV, Grams ME, Chang AR, Jaar B, Gansevoort RT, Bridges JFP, Kovesdy CP, Uchida S, Coresh JJ
Secondary AuthorsMatsushita K
JournalAm J Kidney Dis
Volume74
Issue1
Pagination23-35
Date Published2019 07
ISSN1523-6838
KeywordsAged, 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.

DOI10.1053/j.ajkd.2019.01.025
Alternate JournalAm J Kidney Dis
PubMed ID30898360
Grant ListK23 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