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

Abstract

ABSTRACTObjectivesDespite 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.MethodsUsing 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 (→) PPSV23 in a scenario analysis.ResultsOver the course of a lifetime (82 years), 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 €. PCV20 remained cost saving (i.e., dominant) versus SC even in numerous sensitivity analyses. In the scenario analysis, PCV20 also showed to be cost-saving compared to using PCV15→PPSV23.ConclusionsOne 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.HIGHLIGHTSPneumococcal disease causes significant morbidity and mortality among adults in GermanyNew, higher valent vaccines have the potential to reduce disease burden and associated costs in vulnerable populationsver a lifetime, 20-valent pneumococcal conjugate vaccine was found to be cost-saving compared with current standard of care for pneumococcal disease prevention among adults in Germany