Open Access Research article

Budget impact analysis of a pneumococcal vaccination programme in the 65-year-old Spanish cohort using a dynamic model

Roberto Pradas1*, Angel Gil de Miguel2, Alejandro Álvaro2, Ruth Gil-Prieto2, Reyes Lorente1, Cristina Méndez3, Pablo Guijarro3 and Fernando Antoñanzas1

Author Affiliations

1 Universidad de la Rioja, Logroño, La Rioja, Spain

2 Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain

3 Pfizer Spain, Alcobendas, , Madrid, Spain

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BMC Infectious Diseases 2013, 13:175  doi:10.1186/1471-2334-13-175

Published: 11 April 2013



This study aimed to assess the costs and clinical benefits of the 13-valent pneumococcal conjugate vaccine (PCV13) administered annually to the 65-year-old cohort in Spain versus the alternative of not vaccinating patients and treating them only when infected.


Cases of pneumococcal disease avoided were calculated through a dynamic model based on the work of Anderson and May (1999). Sixty-six percent of the 65-year-old cohort was assumed to have been vaccinated with one PCV13 dose (304,492 subjects). Base-case estimated vaccine effectiveness and serotype coverage were 58% and 60%, respectively. Disease-related costs were calculated based on published data.


Over the 5-year period, a total of 125,906 cases of pneumococcal disease would be avoided. Net savings of €102 million would be obtained. The cost-saving distribution was not homogeneous, starting in the 2nd year and increasing through the 5th. To demonstrate model robustness, an additional scenario analysis was performed using extreme values of model parameters (vaccination programme coverage, vaccine effectiveness, discount rate and disease costs). Under those scenarios, net savings were always achieved.


Based on the assumptions of the model, the 65-year-cohort pneumococcal vaccination campaign appears to be a cost-saving intervention in the Spanish population under different scenarios.