Cost-effectiveness of 20-valent pneumococcal conjugate vaccine in Denmark compared with PPV23

Olsen, Jens; Schnack, Henrik; Skovdal, Mette; Vietri, Jeffrey; Mikkelsen, Malene Buch; Poulsen, Peter Bo

doi:10.1080/13696998.2022.2152235

Cited by 13 publications

(5 citation statements)

References 48 publications

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“…Mendes and colleagues and Olsen and colleagues found that PCV20 was cost saving compared with current recommendations (i.e., PPV23) in a cohort of all adults aged ≥65 years and moderate- and high-risk adults aged 18-64 years in England and Denmark, respectively. [45,46] In an analysis conducted by the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) considering all adults aged ≥65 years and adults aged 19-64 years with chronic medical or immunocompromising conditions, a single dose of PCV20 was found to be cost saving compared with 2019 ACIP recommendations, which included age/risk dependent use of PPV23 alone or PCV13→PPV23. [47] We note that in a recent analysis by Smith et al, PCV20 use (vs. 2019 ACIP recommendations) among elderly US adults was found to cost $172,491 per QALY, however, differences in findings (compared with aforementioned US CDC analysis) are believed to be due, at least in part, to variation in model populations (e.g., Smith et al excluded immunocompromised patients) as well as key parameter values (e.g., rates of pneumonia were assumed by Smith et al to be lower).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of use of 20-valent pneumococcal conjugate vaccine among adults in Germany

Kuehne

Achtert²,

Pueschner³

et al. 2023

Preprint

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Objectives. Despite national recommendations for use of pneumococcal vaccines, rates of community-acquired pneumonia (CAP) and invasive pneumococcal disease (IPD) remain high in Germany. New pneumococcal conjugate vaccines (PCVs) with expanded coverage have the potential to reduce the pneumococcal disease burden among adults. Methods. Using a Markov model, we evaluated the lifetime outcomes/costs comparing 20-valent PCV (PCV20) with standard of care (SC) vaccination for prevention of CAP and IPD among adults aged 60 years and at-risk adults aged 18-59 years in Germany. PCV20 also was compared with sequential vaccination with 15-valent PCV (PCV15) followed by PPV23 in a scenario analysis. Results. Use of PCV20 vs. SC would prevent 54,333 hospitalizations, 26,368 outpatient CAP cases, 10,946 disease-related deaths yield 74,694 additional life-years (LYs), while lowering total medical costs by 363.2M Euro. PCV20 was cost saving (i.e., dominant) versus SC. Scenario analysis results suggest that the use of PCV20 would also prevent more cases and deaths, yield more LYs, and result in lower costs than using PCV15→PPV23. Conclusions. One dose of PCV20 among adults aged 60 years and adults aged 18-59 years with moderate- and high-risk conditions would substantially reduce pneumococcal disease, save lives, and be cost saving compared with SC.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of use of 20-valent pneumococcal conjugate vaccine among adults in Germany

Kuehne

Achtert²,

Pueschner³

et al. 2023

Preprint

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“…However, as risk groups are de ned differently in Norway and Denmark, cf. the Danish adaption of the model [20], the Danish mortality rates applied in the Norwegian model adaption could result in either higher or lower mortality estimates.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of 20-valent pneumococcal conjugate vaccine compared with 23-valent pneumococcal polysaccharide vaccine among adults in a Norwegian setting

Mikkelsen,

Husby,

Molden

et al. 2023

Preprint

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Background The morbidity and mortality of adult diseases caused by S. pneumoniae increase with age and presence of underlying chronic diseases. Currently, two vaccine technologies against S. pneumoniae are used: the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the pneumococcal conjugate vaccines, one of which is the 20-valent pneumococcal conjugate vaccine (PCV20) that has recently been approved for adults.Objective This study was conducted to investigate the cost-effectiveness of implementing PCV20 in a reimbursement scheme for Norwegian adults aged 18–99 years at risk of pneumococcal diseases and those aged 65 years and older at low risk compared to PPV23.Methods A Markov model was developed and adapted to a Norwegian setting to estimate the economic and clinical consequences of vaccinating the Norwegian population in specific age and risk groups against pneumococcal diseases. Inputs for the model were found in Norwegian or Danish real-world evidence or retrieved from available studies. The costs and clinical outcomes were assessed using a health sector perspective and a lifetime time horizon.Results The results showed that PCV20 was associated with better health outcomes including fewer disease cases, fewer disease-attributable fatalities, a higher gain of life years and quality-adjusted life years compared to PPV23. In addition, PCV20 had a lower total cost compared to PPV23. Therefore, PCV20 was the dominant vaccination strategy. The base case result was investigated in multiple sensitivity analyses, which showed that the results were robust to changes in input parameters and methodological assumptions, as PCV20 remained the dominant vaccination strategy in almost all scenarios.Conclusion Results showed that vaccinating the Norwegian adults with PCV20 was cost-effective compared to PPV23.

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“…Furthermore, the present model analysis did not include potential adverse events (AE) associated with PCV20, PCV15 and PPV23 vaccination, since most AE are of mild or moderate severity and serious AE are rare, hence the impact on model base case results would be negligible. The same approach has been used also in recent model publications in UK and Denmark (24,34). However, in the absence of differential safety data, incorporating AEs would favor single-dose strategies.…”

Section: Discussionmentioning

confidence: 99%

“…The VE of PPV23 against VT-IPD for low-, moderate-, and highrisk persons was derived for all ages by fitting a logarithmic curve to values for persons aged 65-74, 75-84, and 85-99 years, and then estimating the age-specific values across the three risk groups using relative risks from Djennad et al and the population sizes (33) (Table 1). Based on published studies, it was assumed that the VE of PPV23 against VT-NBP was zero (35, 36) and consistent with basecase assumptions employed in several of economic evaluation studies (24,34,(37)(38)(39). As for the vaccine waning for PPV23, it was obtained from Djennad et al (33), with a linear decline to 76.2% of initial vaccine efficacy by year 5, followed by a linear decline to no efficacy by year 10.…”

Section: Vaccine Coverage and Efficacymentioning

confidence: 99%

Health and economic outcomes of 20-valent pneumococcal conjugate vaccine compared to 15-valent pneumococcal conjugate vaccine strategies for adults in Greece

Gourzoulidis,

Barmpouni,

Kossyvaki

et al. 2023

Front. Public Health

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ObjectiveHigher valency pneumococcal conjugate vaccines (PCVs) are expected to improve protection against pneumococcal disease through coverage of additional serotypes. The aim of the present study was to evaluate the cost-effectiveness of 20-valent pneumococcal conjugate vaccine (PCV20) compared to 15-valent pneumococcal conjugate vaccine (PCV15) alone or followed by 23-valent polysaccharide vaccine (PPV23) for adults in Greece.MethodsA published Markov model was adapted to simulate lifetime risk of clinical and economic outcomes from the public payer’s perspective. The model population was stratified based on age and risk profile (i.e., low, moderate, or high-risk of developing pneumococcal disease). Epidemiologic parameters, serotype coverage and vaccines’ effectiveness were based on published literature, while direct medical costs (prices €, 2022) were obtained from official sources. Main model outcomes were projected number of invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP) cases and attributable deaths, costs and quality-adjusted life-years (QALY) for each vaccination strategy. Sensitivity analyses were performed to ascertain the robustness of model results.ResultsOver the modeled time horizon, vaccination with PCV20 compared to PCV15 alone or PCV15 followed by PPV23 prevents an additional 747 and 646 cases of IPD, 10,334 and 10,342 cases of NBP and 468 and 455 deaths respectively, resulting in incremental gain of 1,594 and 1,536 QALYs and cost savings of €11,183 and €48,858, respectively. PSA revealed that the probability of PCV20 being cost-effective at the predetermined threshold of €34,000 per QALY gained was 100% compared to either PCV15 alone or the combination of PCV15 followed by PPV23.ConclusionPCV20 is estimated to improve public health by averting additional pneumococcal disease cases and deaths relative to PCV15 alone or followed by PPV23, and therefore translates to cost-savings for the public payer. Overall results showed that vaccination with PCV20 was estimated to be a dominant vaccination strategy (improved health outcomes with reduced costs) over PCV15 alone or followed by PPV23 for prevention of pneumococcal disease in adults in Greece.

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Cost-effectiveness of 20-valent pneumococcal conjugate vaccine in Denmark compared with PPV23

Cited by 13 publications

References 48 publications

Cost-effectiveness of use of 20-valent pneumococcal conjugate vaccine among adults in Germany

Cost-effectiveness of use of 20-valent pneumococcal conjugate vaccine among adults in Germany

Cost-effectiveness of 20-valent pneumococcal conjugate vaccine compared with 23-valent pneumococcal polysaccharide vaccine among adults in a Norwegian setting

Health and economic outcomes of 20-valent pneumococcal conjugate vaccine compared to 15-valent pneumococcal conjugate vaccine strategies for adults in Greece

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