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Cost-effectiveness of 20-valent pneumococcal conjugate vaccine in US infants
Mark H Rozenbaum1, Liping Huang2, Johnna Perdrizet3
1Pfizer, Capelle a/d Ijssel, Netherlands.
Insights
New pneumococcal conjugate vaccine 20-valent (PCV20) offers significant health and economic benefits over PCV13 and PCV15. Infant vaccination with PCV20 is projected to avert numerous disease cases and deaths, saving billions.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- Current US infant vaccination schedules include 15-valent (PCV15) and 20-valent (PCV20) pneumococcal conjugate vaccines.
- This study assesses the health and economic impact of utilizing the PCV20 formulation for infant immunization.
Purpose of the Study:
- To evaluate the health and economic consequences of PCV20 infant vaccination compared to existing vaccine recommendations.
- To analyze the cost-effectiveness of PCV20 from both societal and healthcare system viewpoints over a decade.
Main Methods:
- A population-based, multi-cohort Markov model was employed to simulate health and economic outcomes.
- Epidemiological data were sourced from published literature and the Active Bacterial Core Surveillance System (ABCs).
- Vaccine effectiveness estimates were derived from PCV13 effectiveness and PCV7 efficacy studies, with indirect effects analyzed from observational data.
Main Results:
- PCV20 vaccination is estimated to prevent over 55,000 invasive pneumococcal disease (IPD) cases, 2.5 million pneumonia cases, and 5.4 million otitis media (OM) cases.
- This strategy is projected to avert 19,000 deaths, yielding 515,000 life years and 271,000 QALYs gained over 10 years.
- PCV20 demonstrated cost-effectiveness, resulting in net savings of $20.6 billion compared to PCV13 and $9.9 billion compared to PCV15, with significant indirect benefits observed.
Conclusions:
- Infant vaccination with PCV20 is a dominant strategy, outperforming both PCV13 and PCV15 in terms of health gains and cost savings.
- PCV20 significantly reduces pneumococcal disease burden and associated healthcare and societal costs.
Background:
As of June 2023, two pneumococcal conjugate vaccines, 20- (PCV20) and 15- (PCV15) valent formulations, are recommended for US infants under a 3 + 1 schedule. This study evaluated the health and economic impact of vaccinating US infants with a new expanded valency PCV20 formulation.
Methods:
A population-based, multi cohort, decision-analytic Markov model was developed to estimate the public health impact and cost-effectiveness of PCV20 from both societal and healthcare system perspectives over 10 years. Epidemiological data were based on published studies and unpublished Active Bacterial Core Surveillance System (ABCs) data. Vaccine effectiveness was based on PCV13 effectiveness and PCV7 efficacy studies. Indirect impact was based on observational studies. Costs and disutilities were based on published data. PCV20 was compared to both PCV13 and PCV15 in separate scenarios.
Results:
Replacing PCV13 with PCV20 in infants has the potential to avert over 55,000 invasive pneumococcal disease (IPD) cases, 2.5 million pneumonia cases, 5.4 million otitis media (OM) cases, and 19,000 deaths across all ages over a 10-year time horizon, corresponding to net gains of 515,000 life years and 271,000 QALYs. Acquisition costs of PCV20 were offset by monetary savings from averted cases resulting in net savings of $20.6 billion. The same trend was observed when comparing PCV20 versus PCV15, with a net gain of 146,000 QALYs and $9.9 billion in net savings. A large proportion of the avoided costs and cases were attributable to indirect effects in unvaccinated adults and elderly. From a health-care perspective, PCV20 was also the dominant strategy compared to both PCV13 and PCV15.
Conclusions:
Infant vaccination with PCV20 is estimated to further reduce pneumococcal disease and associated healthcare system and societal costs compared to both PCV13 and PCV15.
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