Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 26: Streptococcus pneumoniae
Appendix 26: Streptococcus pneumoniae
Pages 313-322
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From page 313... ...
Disease Scenarios For the purposes of the calculation in this report, the committee assumed that S pneumonias disease manifests as bacteremia and sepsis, pneumonia, otitis media/sinusitis/bronchitis, and meningitis.
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It was assumed that a small percentage of patients with meningitis experience lifelong neurologic sequelae requiring multiple visits to a specialist and some sort of physical or other rehabilitative therapies for the disability.
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complications Meningitis neurologic 60 0.001% 0.60 26.6824 (quality sequelae adjusted life expec tancy) ; 73.4869 (unadjusted life expectancy)
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Bacteremia/Sepsis 4,711 1.18% 0.59 0.0137 (5 days) inpatient; complications PNEUMONIA 235,550 59.21% Pneumonia outpatient 141,330 35.53% 0.82 0.0274 (10 days)
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From page 317... ...
Table 4-1 summarizes vaccine development assumptions for all vaccines considered in this report. VACCINE PROGRAM CONSIDERATIONS Target Population For the purposes of the calculations in this report, it is assumed that the target population for this vaccine is the annual birth cohort and people 65 years of age.
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From page 318... ...
318 VA CCINES FOR THE 21ST CENTURY Table A26-3 Health Care Costs Associated with Streptococcus pneumonias Infection Cost per Cost per Units per Case Unit Case Form of Treatment <5 YEARS OF AGE Bacteremia/Sepsis outpatient care only $100 $50 2.0 physician a $50 $50 1.0 medication b $50 $50 1.0 diagnostic a ICU and post-phase $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $100 $100 1.0 diagnostic b inpatient (no ICU) $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $100 $100 1.0 diagnostic b inpatient; complications $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $500 $500 1.0 diagnostic c Pneumonia outpatient care only $100 $50 2.0 physician a $50 $50 1.0 diagnostic a $50 $50 1.0 medication b inpatient $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $100 $100 1.0 diagnostic b outpatient after inpatient $100 $50 2.0 physician a $50 $50 1.0 medication b $50 $50 1.0 diagnostics Other Respiratory otitis media $50 $50 1.0 physician visits $50 $50 1.0 medication b $50 $50 1.0 diagnostic a Meningitis ICU and non-ICU $7,000 $7,000 1.0 hospitalization combine meningitis for costs $450 $150 3.0 physician b $50 $50 1.0 medication b $100 $100 1.0 diagnostic b $500 $500 1.0 diagnostic c inpatient, acutecomplica- $7,000 $7,000 1.0 hospitalization lions $900 $150 6.0 physician b $50 $50 1.0 medication b $100 $100 1.0 diagnostic b $500 $500 1.0 diagnostic c Meningitis: sequelae lifelong annual costs $600 $100 6.0 physician b $300 $50 6.0 physical therapy, other services
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From page 319... ...
APPENDIX26 Table A26-3 Continued 319 Cost per Cost per Units per Case Unit Case Form of Treatment 5-64 YEARS OF AGE Bacteremia/Sepsis outpatient care only $100 $50 2.0 physician visits $50 $50 1.0 medication b $50 $50 1.0 diagnostic a ICU and post- phase $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $100 $100 1.0 diagnostic b inpatient (no ICU) $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $100 $100 1.0 diagnostic b inpatient; complications $4,000 $4,000 1.0 hospitalization $300 $100 3.0 physician b $500 $500 1.0 diagnostic c Pneumonia outpatient care only $200 $100 2.0 physician b $100 $50 2.0 diagnostic a $50 $50 1.0 medication b Pneumonia with and without emphysema inpatient $4,000 $4,000 1.0 hospitalization $450 $150 3.0 physician c $100 $100 1.0 diagnostic b $50 $50 1.0 medication b outpatient after inpatient $100 $50 2.0 physician visits $50 $50 1.0 medication b sinusitis, bronchitis Meningitis $100 $50 2.0 physician a $50 $50 1.0 medication b $50 $50 1.0 diagnostic b ICU, post-ICU, and non- $7,000 $7,000 1.0 hospitalization ICU $450 $150 3.0 physician c $50 $50 1.0 medication b $100 $100 1.0 diagnostic b $500 $500 1.0 diagnostic c Meningitis: sequelae cost per year for life $300 $50 6.0 physical therapy $600 $100 6.0 physician b >65 YEARS OF AGE+ Bacteremia/Sepsis outpatient care only $100 $50 2.0 physician a $50 $50 1.0 medication b $50 $50 1.0 diagnostic a ICU and post ICU phase: $4,000 $4,000 1.0 hospitalization inpatient $300 $100 3.0 physician b $100 $100 1.0 diagnostic b Continued
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From page 320... ...
Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the QALYs gained would be 120,000.
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From page 321... ...
Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $815 million. If a vaccine program for S
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From page 322... ...
Wenger JD, Hightower AW, Facklam RR, et al. Bacterial Meningitis in the United States, 1986: Report of a Multistate Surveillance Study.
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