Cost-effectiveness of the 15-valent pneumococcal conjugate vaccine for high-risk adults in Switzerland

ABSTRACT

Background

Vaccination against pneumococcal disease (PD) has shown a favorable cost-effectivenessprofile for many national immunization programs. While vaccination efforts have concentrated on children, many adults with underlying illnesses face elevated risks of PD and death. A 15-valent pneumococcal conjugate vaccine (V114) is currently available offering protection against 15 different serotypes and can be used in adults.

Research design and methods

We examined the cost-effectiveness of V114 vaccination in high-risk adults, aged 18+, in Switzerland. To this end, a Markov model was constructed estimating the lifetime direct medical costs and clinical effectiveness of V114 vaccination on invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP).

Results

Considering 60% vaccine uptake and direct effects of vaccination, in total 760 IPD and 4,396 NBPP in- and outpatient cases could be prevented. Vaccinating high-risk adults with V114 led to CHF 37.4 million additional vaccination costs but saved CHF 14.4 million of medical treatment costs. V114 vaccination produced a gain of 2,095 QALYs and 6,320 LYs compared with no vaccination, leading to incremental cost-effectiveness ratios of CHF 17,866/QALY and CHF 15,616/QALY gained from a health care payer and societal perspective, respectively.

Conclusions

This evidence justifies the implementation of V114 vaccination among high-risk adults in Switzerland.

KEYWORDS:

• Pneumococcal disease
• pneumococcal vaccination
• Switzerland
• non-bacteremic pneumococcal pneumonia
• conjugate vaccine
• high-risk adults

Author contributions

A.D., P.G., T.M., K.OE., T.I., D.A.R.M. and V.Q. were involved in the conception and design of the analysis and in the interpretation of the data. P.G. and T.M. have worked on the collection of local model input data. All authors contributed to the drafting of the paper and have critically revised it for intellectual content. All authors have approved the final version to be submitted for publication, and all authors agree to be accountable for all aspects of the work.

Declaration of interests

V Qendri, T Ignacio and D A.R. Mathijssen have received consultancy fees from MSD. T Ignacio and D A.R. Mathijssen have received consultancy fees from MSD for other work related to the product of relevance in this manuscript; these fees were collected by his/her employer. V Qendri has received honoraria from MSD for participation in an expert meeting for a different product than the one treated in this manuscript. P Guggisberg and T Mutschler are employees of MSD Merck Sharp & Dohme AG, Switzerland, and have stock options for Merck & Co., Inc., Kenilworth, NJ, USA. G Bencina is an employee of MSD, Spain, and has stock options for Merck & Co., Inc., Kenilworth, NJ, USA. A Deb, K Owusu-Edusei and K D. Johnson are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Reviewer disclosures

Reviewers on this manuscript have received honoraria for their review work. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by Merck Sharp & Dohme (MSD).