Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions
In June 2019, the Advisory Committee on Immunization Practices (ACIP) changed the recommendation for routine 13-valent pneumococcal conjugate vaccine (PCV13) use in immunocompetent adults aged ≥65 years, including those with select chronic medical conditions (CMC). ACIP now recommends PCV13 for this...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-07-01
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| Series: | Human Vaccines & Immunotherapeutics |
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| Online Access: | http://dx.doi.org/10.1080/21645515.2020.1861876 |
| _version_ | 1797677236408549376 |
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| author | Miwako Kobayashi Charles Stoecker Wei Xing Bo-Hyun Cho Tamara Pilishvili |
| author_facet | Miwako Kobayashi Charles Stoecker Wei Xing Bo-Hyun Cho Tamara Pilishvili |
| author_sort | Miwako Kobayashi |
| collection | DOAJ |
| description | In June 2019, the Advisory Committee on Immunization Practices (ACIP) changed the recommendation for routine 13-valent pneumococcal conjugate vaccine (PCV13) use in immunocompetent adults aged ≥65 years, including those with select chronic medical conditions (CMC). ACIP now recommends PCV13 for this group of adults based on shared clinical decision-making. Because adults with CMC continue to be at increased risk for pneumococcal disease, we assessed the cost-effectiveness of administering PCV13 in series with the recommended 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults aged ≥19 years with CMC. We used a probabilistic model following a cohort of 19-year-old adults. We used Monte Carlo simulation to estimate the impact on program, medical, and non-medical costs (in 2017 U.S. dollars [$], societal perspective), and pneumococcal disease burden when administering PCV13 in series with PPSV23. We used PCV13 efficacy and post-licensure vaccine effectiveness (VE) data to estimate VE against PCV13 type disease (separately for disease by serotype 3 [ST3], the most common PCV13 type, and all other PCV13 serotypes). We considered a range of estimates for sensitivity analyses. Analyses were performed in 2019. In the base case, assuming no PCV13 effectiveness against ST3 disease, adding a dose of PCV13 upon CMC diagnosis cost $689,299 per QALY gained. This declined to $79,416 per QALY if VE against ST3 was estimated to be equivalent to other PCV13-types. Administering PCV13 in series with the recommended PPSV23 for adults with CMC was not cost saving. Results were sensitive to estimated PCV13 VE against ST3 disease. |
| first_indexed | 2024-03-11T22:42:08Z |
| format | Article |
| id | doaj.art-bcd6f3785dd148fb9223c132403ffcba |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T22:42:08Z |
| publishDate | 2021-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-bcd6f3785dd148fb9223c132403ffcba2023-09-22T08:51:53ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2021-07-011772232224010.1080/21645515.2020.18618761861876Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditionsMiwako Kobayashi0Charles Stoecker1Wei Xing2Bo-Hyun Cho3Tamara Pilishvili4National Center for Immunization and Respiratory Diseases, Centers for Disease Control and PreventionTulane University School of Public Health and Tropical MedicineNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and PreventionNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and PreventionIn June 2019, the Advisory Committee on Immunization Practices (ACIP) changed the recommendation for routine 13-valent pneumococcal conjugate vaccine (PCV13) use in immunocompetent adults aged ≥65 years, including those with select chronic medical conditions (CMC). ACIP now recommends PCV13 for this group of adults based on shared clinical decision-making. Because adults with CMC continue to be at increased risk for pneumococcal disease, we assessed the cost-effectiveness of administering PCV13 in series with the recommended 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults aged ≥19 years with CMC. We used a probabilistic model following a cohort of 19-year-old adults. We used Monte Carlo simulation to estimate the impact on program, medical, and non-medical costs (in 2017 U.S. dollars [$], societal perspective), and pneumococcal disease burden when administering PCV13 in series with PPSV23. We used PCV13 efficacy and post-licensure vaccine effectiveness (VE) data to estimate VE against PCV13 type disease (separately for disease by serotype 3 [ST3], the most common PCV13 type, and all other PCV13 serotypes). We considered a range of estimates for sensitivity analyses. Analyses were performed in 2019. In the base case, assuming no PCV13 effectiveness against ST3 disease, adding a dose of PCV13 upon CMC diagnosis cost $689,299 per QALY gained. This declined to $79,416 per QALY if VE against ST3 was estimated to be equivalent to other PCV13-types. Administering PCV13 in series with the recommended PPSV23 for adults with CMC was not cost saving. Results were sensitive to estimated PCV13 VE against ST3 disease.http://dx.doi.org/10.1080/21645515.2020.186187613-valent pneumococcal conjugate vaccineunited statesadultschronic underlying conditionsrisk-based recommendation |
| spellingShingle | Miwako Kobayashi Charles Stoecker Wei Xing Bo-Hyun Cho Tamara Pilishvili Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions Human Vaccines & Immunotherapeutics 13-valent pneumococcal conjugate vaccine united states adults chronic underlying conditions risk-based recommendation |
| title | Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions |
| title_full | Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions |
| title_fullStr | Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions |
| title_full_unstemmed | Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions |
| title_short | Cost-effectiveness of implementing 13-valent pneumococcal conjugate vaccine for U.S. adults aged 19 years and older with underlying conditions |
| title_sort | cost effectiveness of implementing 13 valent pneumococcal conjugate vaccine for u s adults aged 19 years and older with underlying conditions |
| topic | 13-valent pneumococcal conjugate vaccine united states adults chronic underlying conditions risk-based recommendation |
| url | http://dx.doi.org/10.1080/21645515.2020.1861876 |
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