Cost-benefit analysis of an immunization program for pneumococcal pneumonia in a health maintenance organization

This study determined whether an immunization program aimed at pneumococcal pneumonia could be justified on a cost-benefit basis. The population considered was that of Family Health Program, a health maintenance organization located in Salt Lake City. Standard methods of cost-benefit analysis including consideration of direct and indirect costs and benefits were adapted to a decision-analysis-based mathematical model. When direct costs and benefits only were evaluated neither an immunization program aimed at all adults nor one aimed at those traditionally considered to be high risk of development of the disease could be justified. This conclusion was relatively insensitive to variation of the input variables used. It was demonstrated however that if a pool of "very high risk" individuals could be identified, then a immunization program aimed solely at them could be justified. When direct and indirect costs and benefits were evaluated it was determined that an immunization program could be justified if it were aimed at those traditionally considered to be at high risk of development of pneumococcal pneumonia.