A public health and budget impact analysis of vaccinating at-risk adults and the elderly against pneumococcal diseases in Germany

Abstract

To assess the comparative public health and budget impact over 5 years of several pneumococcal vaccination strategies (23-valent pneumococcal polysaccharide vaccine [PPV23] and/or 13-valent pneumococcal conjugate vaccine [PCV13]) in Germany, within the context of changing invasive pneumococcal disease (IPD) incidence over time. A multi-cohort, population-based Markov model was developed. Uncertainty around vaccine effectiveness, costs and IPD incidence change was handled through scenario analyses. Between 2012 and 2016, the introduction of PCV13 in adults, compared with the use of PPV23, would be associated with a net estimated budget increase of €59.7 million (+6.7%) to €151.6 million (+13.7%). Impact on IPD incidence ranged from -113 cases (-0.8%) to +298 cases (+2.8%). Introducing PCV13 in adults is expected to significantly affect healthcare budgets. Adult vaccination with PPV23 remains the optimal vaccination strategy from public health and budget perspectives.

Keywords::

• budget impact analysis
• conjugate pneumococcal vaccine
• epidemiological changes
• invasive pneumococcal diseases
• pneumococcal pneumonia
• polysaccharide pneumococcal vaccine
• public health

Acknowledgements

The authors thank F Baron-Papillon (Sanofi Pasteur MSD) for her assistance in reviewing the manuscript.

Disclaimer

The authors take sole responsibility for the content of this article.

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, and 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.