Cost-effectiveness and impact on infections and associated antimicrobial resistance of 20-valent pneumococcal conjugate vaccine in US children previously immunized with PCV13

Abstract

Aim

The US Food and Drug Administration approved the 20-valent pneumococcal conjugate vaccine (PCV20) to prevent pneumococcal disease. In the context of routine PCV20 vaccination, we evaluated the cost-effectiveness and public health and economic impact of a PCV20 catch-up program and estimated the number of antibiotic prescriptions and antibiotic-resistant infections averted.

Materials and methods

A population-based, multi-cohort, decision-analytic Markov model was developed using parameters consistent with previous PCV20 cost-effectiveness analyses. In the intervention arm, children aged 14–59 months who previously completed PCV13 vaccination received a supplemental dose of PCV20. In the comparator arm, no catch-up PCV20 dose was given. The direct and indirect benefits of vaccination were captured over a 10-year time horizon.

Results

A PCV20 catch-up program would prevent 5,469 invasive pneumococcal disease cases, 50,286 hospitalized pneumonia cases, 218,240 outpatient pneumonia cases, 582,302 otitis media cases, and 1,800 deaths, representing a net gain of 30,014 life years and 55,583 quality-adjusted life years. Furthermore, 720,938 antibiotic prescriptions and 256,889 antibiotic-resistant infections would be averted. A catch-up program would result in cost savings of $800 million. These results were robust to sensitivity and scenario analyses.

Conclusions

A PCV20 catch-up program could prevent pneumococcal infections, antibiotic prescriptions, and antimicrobial-resistant infections and would be cost-saving in the US.

Keywords:

• 20-Valent pneumococcal conjugate vaccine
• antibiotic prescriptions
• antimicrobial resistance
• catch-up program
• supplemental vaccination
• cost-effectiveness analysis
• pneumococcal disease

JEL CLASSIFICATION CODES:

• I10
• I1
• I
• I00

Transparency

Declaration of funding

This work was funded by Pfizer. Evidera received financial support from Pfizer in connection with the study and the development of this manuscript.

Declaration of financial/other relationships

AC, LH, AAM, MT, VS, EC, RF, and MR are employed by Pfizer Inc. RC and DDM are employed by Evidera Inc., which received financial support from Pfizer Inc. for this study and the development of this manuscript.

Author contributions

Conceptualization, MR, LH, AC, AA, RC, MT, VS, EC, and RF; formal analysis, MR and RC; methodology, MR, RC, EC, and RF; project administration, RC; supervision, MR; validation, MR and RC; visualization, RC; writing–original draft, MR, RC, and EC; writing–review and editing, MR, LH, AC, AA, RC, MT, VS, EC, and RF.

Acknowledgements

Medical writing support was provided by Dr. Ruth Sharf at Evidera, which was funded by Pfizer.

Data availability statement

All data analyzed in this study are included within the article or Supplementary Material.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.