Cost–effectiveness of vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany

Abstract

The introduction of routine infant vaccination against pneumococcal disease has resulted in a decreased overall invasive pneumococcal disease incidence in adults but also a change in invasive pneumococcal disease serotypes. This study aimed to assess the cost–effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany in this context. A population-based Markov model was developed. A cohort of adults currently eligible for vaccination was followed until death. Adult vaccination with PPV23 was associated with an incremental cost–effectiveness ratio of €17,065/quality-adjusted life years gained from the third-party payer’s perspective. Univariate sensitivity analyses showed that the incremental cost–effectiveness ratio was below €50,000/quality-adjusted life years gained in most test scenarios. The model suggests that adult PPV23 vaccination is cost effective in Germany, due to its broad serotype coverage. This is despite epidemiological changes in Streptococcus pneumoniae serotypes caused by wider use of pneumococcal conjugate vaccines during childhood.

Keywords::

• cost–effectiveness analysis
• epidemiological changes
• invasive pneumococcal diseases
• pneumococcal pneumonia
• polysaccharide pneumococcal vaccine

Financial & competing interests disclosure

This study was conducted by Amaris and funded by Sanofi Pasteur MSD. Y Jiang and A Gauthier are employees of Amaris. L Annemans received a consultancy fee from Sanofi Pasteur MSD for his role as an advisor in the design of the model. M van der Linden has received research grants from GlaxoSmithKline, Pfizer and Sanofi Pasteur MSD, is a member of advisory boards for GlaxoSmithKline, has received speakers’ honoraria from GlaxoSmithKline, Pfizer and Sanofi Pasteur MSD. L Nicolas-Spony and X Bresse are employees of Sanofi Pasteur MSD. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.