Cost-effectiveness of vaccinating for invasive pneumococcal disease in the elderly in the Lazio region of Italy

Pneumococcal vaccination among the elderly is currently recommended in several western countries. We estimated the cost-effectiveness of a hypothetical vaccination campaign of 65+ year olds in the Lazio region (Italy). Baseline net costs per event averted and life-year gained, at 2001 prices, were €34,681 (95%CI: €28,699 to €42,929) and €23,361, respectively (95%CI: €16,419 to €38,297). Lower bacteraemic pneumonia incidence and vaccine effectiveness increased the net cost per life-year gained (ICER) to €53,899 and €74,313, respectively; in the best-case scenario the ICER was €4249. The case definition of invasive pneumococcal disease and, consequently, vaccine effectiveness are major uncertainties in countries with low incidence of pneumonia.