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Cost-effectiveness models of pneumococcal conjugate vaccines: variability and impact of modeling assumptions

Raymond A Farkouh1, Rogier M Klok, Maarten J Postma

  • 1Pfizer Inc., 500 Arcola Road, Collegeville, PA 19426, USA. rfarkouh@pfizer.com

Expert Review of Vaccines
|November 23, 2012
PubMed

Insights

Cost-effectiveness of pneumococcal conjugate vaccines (PCV) is complex. Assumptions about vaccine effectiveness, particularly against otitis media and indirect effects, significantly impact economic analyses for ten-valent and 13-valent PCV.

Area of Science:

  • * Public Health
  • * Health Economics
  • * Vaccinology

Background:

  • * Current 13-valent pneumococcal conjugate vaccine (PCV) and ten-valent PCV vaccines were approved based on immunogenicity, not direct efficacy trials.
  • * This lack of direct efficacy data complicates economic evaluations.
  • * Assumptions regarding vaccine effectiveness are critical for cost-effectiveness analyses.

Purpose of the Study:

  • * To systematically review cost-effectiveness studies of ten-valent and 13-valent PCV.
  • * To analyze methodologies and compare assumptions about vaccine effectiveness.
  • * To discuss the implications of these assumptions on decision-making.

Main Methods:

  • * Systematic literature review of cost-effectiveness studies for ten-valent and 13-valent PCV.
  • * Analysis of methodologies and key assumptions used in economic evaluations.
  • * Identification of the most variable inputs across studies.

Main Results:

  • * Key assumptions influencing cost-effectiveness analyses include efficacy against acute otitis media, inclusion of indirect effects, and cross-protection.
  • * These three factors showed the most variation across the reviewed studies.
  • * The validity of supporting data for these assumptions impacts the reliability of economic models.

Conclusions:

  • * Variability in assumptions about vaccine effectiveness significantly affects cost-effectiveness findings for PCVs.
  • * Critical evaluation of data supporting assumptions on otitis media efficacy, indirect effects, and cross-protection is necessary.
  • * Understanding these variations is crucial for informed public health and policy decisions regarding PCV implementation.

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