Cost Effectiveness of Pcv13 Vs Ppsv23 For The Immunization of Adults Over 65 Years with Low or Moderate Risk of Pneumococcal Infection

Abstract

A931system. Methods: A cost-effectiveness analysis was performed considering six subgroups within the target population (three age groups and two risk groups) and a time horizon of twenty years. A single-dose of PCV13 was compared to a PPSV23 scheme with a reinforcing dose every five years. The model considers two forms of pneumococcal infection: invasive pneumococcal disease (bacteremia and meningitis) and community acquired pneumonia. Subject to availability, the model was mainly fed with inputs based on published local epidemiology data. The vaccine efficacy rates were estimated for each subgroup based on available clinical trials on the target population. The costs considered within the model are based on the local costs published by institutions of the Mexican public health system. Results: Considering a time horizon of twenty years: PCV13 yielded 0.6484 additional life years per patient over PPSV23 and PCV13 yielded savings of $525.39 MNX per patient over PPSV23. Hence, PCV13 is a dominant immunization strategy over PPSV23. ConClusions: Choosing PCV13 as an immunization strategy for adults over 65 years with low or moderate risk of pneumococcal infection would significantly reduce the number of community acquired pneumonia events. Hence, the use of PCV13 would reduce the clinical and economic burden associated with pneumococcal infections expected on the target population. Sensibility analyses considering the lowest possible healthcare costs and a single dose scheme of PPSV23 did not modify the results of the model.