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

Author:

Mikkelsen Malene Buch1,Husby Oyvind2,Molden Tor2,Mwaura David Ngaruiya2,Olsen Jens1,Kristensen Nanna Vestergaard1,Vietri Jeffrey3

Affiliation:

1. EY

2. Pfizer Norway

3. Pfizer Inc

Abstract

Abstract 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.

Publisher

Research Square Platform LLC

Reference54 articles.

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2. PCV13 Vaccination of Adults against Pneumococcal Disease: What We Have Learned from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA);Theilacker C;Microorganisms,2022

3. Plotkin SA, Orenstein WA, Offit PA, editors. Plotkin’s vaccines, Chap. 46–47. Seventh edition. Philadelphia, PA: Elsevier; 2018.

4. Winje BA, Berild JD, Vestrheim DF, et al. Efficacy and effectiveness of pneumococcal vaccination in adults – a second update of the literature [Effekt av pneumokokkvacsine hos eldre]. Oslo: Norwegian Institute of Public Health; 2022.

5. Nymark LS, Dag Berild J, Lyngstad TM et al. Cost-utility analysis of the universal pneumococcal vaccination programme for older adults in Norway. Hum Vaccines Immunother. 2022;2101333.

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