Comment on “Modeling the cost-effectiveness of infant vaccination with pneumococcal conjugate vaccines in Germany”

Excerpt

The paper by Kuhlmann and Graf von der Schulenburg [1] suffers from a number of shortcomings. First, the QALY calculation is flawed. Based on the data provided in Table 9 of their article (see below), dividing the number of QALYs gained by the number of life years gained yields a ratio of just 0.56. Yet, this ratio cannot be explained by the QALY weights listed in Table 6 (as a side note, the base-case values listed in Table 6 for the complications of pneumococcal infection need to refer to a loss of health-related quality of life and not to health-related quality of life per se, as presented). Even if PCV13 were purely life extending, the ratio would be larger as the lowest QALY weight in the population without pneumococcal infection is already 0.59. But in addition to its life extending effect the vaccine, of course, prevents pneumococcal infection and its complications which further increases the number of QALYs gained and therefore increases the ratio of number of QALYs to number of life years above the ratio of 0.59. In sum, the number of QALYs gained is underestimated based on the model input data. …