Cost-effectiveness of the 15-valent pneumococcal conjugate vaccine for high-risk adults in Switzerland

Deb, Arijita; Guggisberg, Patrik; Mutschler, Thomas; Owusu-Edusei, Kwame; Benčina, Goran; Johnson, Kelly; Ignacio, Tim; Mathijssen, Daan; Qendri, Venetia

doi:10.1080/14760584.2022.2046468

Cited by 4 publications

(5 citation statements)

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“…A similar focus on the benefits of the introduction of PCV15 in high-risk immunosuppressed patients was recently published by Deb A. (2021) for Switzerland [ 14 ]. In this study, the proportion of subjects in immunocompetent and immunosuppressed groups was estimated at 6.7%, and 3.8%, respectively, of the total Swiss population, and immunization with PCV15 led to a favorable incremental cost-effectiveness ratio (CHF 15,616/QALY) from a societal perspective.…”

Section: Discussionmentioning

confidence: 86%

“…The scenario analyses using GMT as a proxy for VE did partly account for this uncertainty. However, inferring VE from OPA GMT ratios is an explorative methodological assumption, and its results deserve a discussion, as the alternative is to consider all new conjugate vaccines equally effective [ 14 ]. More research on the relationship between GMT and VE would be needed to support this assumption.…”

Section: Discussionmentioning

confidence: 99%

“…To assess the cost-effectiveness of PCV15 + PPSV23 versus other strategies in various adult risk groups in Italy, a previous published multi-state Markov model was used (Figure 1). The complete details of the Markov model structure are described in Deb et al, 2022 [14]. and death.…”

Section: Model Structurementioning

confidence: 99%

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Cost-Effectiveness of Pneumococcal Vaccination in Adults in Italy: Comparing New Alternatives and Exploring the Role of GMT Ratios in Informing Vaccine Effectiveness

et al. 2023

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In Italy, a sequential pneumococcal vaccination with conjugate vaccine (PCV) and polysaccharide vaccine (PPSV23) is recommended for individuals aged ≥ 65 years and those at risk for pneumococcal disease (PD) aged ≥ 6 years. The aim of this study was to assess the cost-effectiveness of the new vaccines, i.e., approved 15-valent and 20-valent PCVs. A published Markov model was adapted to evaluate the lifetime cost-effectiveness of vaccination with PCV15 + PPSV23 versus PCV13 + PPSV23, PCV20 alone, PCV20 + PPSV23, and No Vaccination. Simulated cohorts representing the Italian population, including individuals aged ≥ 65 years, those at risk aged 50–100 years, and those deemed high risk aged 18–100 years were assessed. Outcomes were accrued in terms of incremental PD cases, costs, quality-adjusted life years, life years, and the cost–utility ratio relative to PCV13 + PPSV23. The conservative base case analysis, including vaccine efficacy based on PCV13 data, showed that sequential vaccination with PCV15 or PCV20 in combination with PPSV23 is preferred over sequential vaccination with PCV13 + PPSV23. Especially in the high-risk group, PCV15 + PPSV23 sequential vaccination was dominant over No Vaccination and resulted in an ICUR of €3605 per QALY gained. Including PCV20 + PPSV23 into the comparison resulted in the domination of the PCV15 + PPSV23 and No Vaccination strategies. Additionally, explorative analysis, including the geometric mean titer (GMT) informed vaccine effectiveness (VE) was performed. In the low-risk and high-risk groups, the results of the GMT scenarios showed PCV15 + PPSV23 to be dominant over the other sequential vaccines. These findings suggest that if real-world studies would confirm a difference in vaccine effectiveness of PCV15 and PCV20 versus PCV13 based on GMT ratios, PCV15 + PPSV23 could prove a highly immunogenic and effective vaccination regime for the Italian adult population.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of Pneumococcal Vaccination in Adults in Italy: Comparing New Alternatives and Exploring the Role of GMT Ratios in Informing Vaccine Effectiveness

et al. 2023

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“…This is unrealistic as the risk of IPD is expected to change over time with changing vaccine (and vaccine recommendations) in the USA. However, this assumption is typical for Markov/ static models [3,[17][18][19][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. In addition, the comprehensive one-way sensitivity analysis addressed this limitation to some extent.…”

Section: Limitationsmentioning

confidence: 99%

Lifetime Health and Economic Burden of Invasive Pneumococcal Diseases Attributable to V116 Serotypes Among Adults in the United States

Yi,

Johnson,

Owusu-Edusei

2024

Infect Dis Ther

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Introduction: This study aimed to estimate and compare the lifetime clinical and economic burden of invasive pneumococcal diseases (IPD) attributable to the serotypes contained in a new 21-valent pneumococcal conjugate vaccine (V116) vs. the 20-valent pneumococcal conjugate vaccine (PCV20) among adults aged 18 years and above in the USA. Methods: A state-transition Markov model was used to track IPD cases and deaths as well as the associated direct medical costs (in 2023 US dollars) from a US healthcare payer perspective at 3% annual discount rate. The results were

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“…Since September 2023, PCV20 is recommended in Germany for all individuals aged 60 years and older and for all individuals aged 18-59 years with underlying diseases. A cost-effectiveness analysis (CEA) in the German adult population concluded that a single dose of PCV20 for adults aged ≥60 years and adults aged 18-59 years with moderate– and high-risk conditions would prevent pneumococcal disease cases, save lives, and would be cost-saving compared to the pneumococcal polysaccharide vaccine (PPSV23) alone, PCV13 followed by PPSV23, or PCV15 followed by PPSV23[16].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of PCV20 to Prevent Pneumococcal Disease in the Pediatric Population - A German Societal Perspective Analysis

Ta,

Kühne,

Laurenz

et al. 2024

Preprint

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BackgroundThe 13-valent pneumococcal conjugate vaccine (PCV13) has been included by Germany’s Standing Committee on Vaccinations for infants since 2009, resulting in major reductions in pneumococcal disease (PD). Higher-valent vaccines may further reduce PD burden. This cost-effectiveness analysis compared PCV20 under 3+1 schedule with PCV15 and PCV13, both under 2+1 schedule, in Germany’s pediatric population.MethodsA Markov model with annual cycles over a 10-year time horizon was adapted to simulate the clinical and economic consequences to the German population and compare pediatric vaccination with PCV20 to lower-valent PCVs. The model used PCV13 clinical effectiveness and impact studies as well as PCV7 efficacy studies for vaccine direct and indirect effect estimates. Epidemiologic, utility, and medical cost inputs were obtained from published sources. Benefits and costs were discounted at 3% from a German societal perspective. Outcomes included PD cases, deaths, costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs).ResultsIn the base case, PCV20 provided greater health benefits than PCV13, averting more cases of invasive pneumococcal disease (IPD; 15,301), hospitalized and non-hospitalized pneumonia (460,197 and 472,365, respectively), otitis media (531,634), and 59,265 deaths over 10 years. This resulted in 904,854 additional QALYs and a total cost-saving of €2,393,263,611, making PCV20 a dominant strategy compared with PCV13. Compared to PCV15, PCV20 was estimated to avert an additional 11,334 IPD, 704,948 pneumonia, and 441,643 otitis media cases, as well as 41,596 deaths. PCV20 was associated with a higher QALY gain and lower cost (i.e., dominance) compared with PCV15. The robustness of the results was confirmed through scenario analyses as well as deterministic and probabilistic sensitivity analyses.ConclusionPCV20 3+1 dominated both PCV13 2+1 and PCV15 2+1 over the model time horizon. Replacing lower-valent PCVs with PCV20 would result in greater clinical and economic benefits, given PCV20’s broader serotype coverage.Key Summary PointsStreptococcus pneumoniaeis the leading cause of bacterial pneumonia and global mortality in children.Pneumococcal conjugate vaccines (PCVs) elicit robust and durable immune responses in both pediatric and adult populations.This study examined the cost-effectiveness of PCV20 under a 3+1 schedule in Germany’s pediatric population compared with PCV13 and a secondary comparator (PCV15), both under a 2+1 schedule.PCV20 was estimated to prevent more pneumococcal disease cases and deaths versus PCV13 and PCV15, as well as providing greater quality-adjusted life years and cost savings (i.e., dominant strategy) over 10 years.Implementation of PCV20 under a 3+1 schedule into the German pediatric immunization program would result in greater clinical and economic benefits versus PCV13 and PCV15, both under a 2+1 schedule.Plain language summaryPneumococcal diseases (e.g., ear infections, pneumonia, bloodstream infections) are among the leading causes of illness and death in children worldwide. The pneumococcal conjugate vaccine (PCV) protects against pneumococcal diseases and has significantly reduced the number of newly diagnosed cases. Higher-valent vaccines (which provide coverage for a greater number of disease-causing serotypes) have recently received EC approval for use in adults and EC approval for use in infants is expected soon. This study examined costs and health benefits associated with the 20-valent PCV (PCV20) under a 3+1 (i.e., three primary doses and one booster dose) schedule in Germany’s childhood vaccination program compared with 13-valent PCV (PCV13) and the 15-valent PCV (PCV15), both under a 2+1 (two primary doses, one booster) schedule. PCV20 was estimated to result in greater health benefits from avoiding more cases in pneumococcal diseases and lower costs compared with both PCV13 and PCV15. PCV20, therefore, is considered the best option among the three vaccines for children in Germany.

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Cost-effectiveness of the 15-valent pneumococcal conjugate vaccine for high-risk adults in Switzerland

Cited by 4 publications

References 50 publications

Cost-Effectiveness of Pneumococcal Vaccination in Adults in Italy: Comparing New Alternatives and Exploring the Role of GMT Ratios in Informing Vaccine Effectiveness

Cost-Effectiveness of Pneumococcal Vaccination in Adults in Italy: Comparing New Alternatives and Exploring the Role of GMT Ratios in Informing Vaccine Effectiveness

Lifetime Health and Economic Burden of Invasive Pneumococcal Diseases Attributable to V116 Serotypes Among Adults in the United States

Cost-effectiveness of PCV20 to Prevent Pneumococcal Disease in the Pediatric Population - A German Societal Perspective Analysis

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