COST-EFFECTIVENESS OF PCV13 IN IMMUNOCOMPETENT US ADULTS AGED 65 YEARS: IMPORTANCE OF VACCINE EFFECTIVENESS AGAINST SEROTYPE 3
Accumulating—albeit limited—evidence indicates that PCV13 is effective against serotype 3 (ST3), which causes a disproportionate share of pneumococcal disease in US adults. Estimates of protection employed in economic evaluations have varied widely; we thus examined the importance of vaccine effectiveness (VE) against ST3 in determining the cost-effectiveness of PCV13.
A probabilistic cohort model depicting risks and costs of pneumococcal disease was employed to evaluate the cost per QALY gained with PCV13->PPSV23 versus PPSV23 alone in immunocompetent US adults aged 65 years under alternative assumptions regarding VE-PCV13 versus ST3. VE-PCV13 (excl. ST3) was based on data from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA); VE-PPSV23 against IPD was based on published literature, and against CAP, was zero.
Cost per QALY gained with PCV13->PPSV23 (vs. PPSV23) ranged from $449,304 to $184,807 when varying VE-PCV13 versus ST3 from 0% to 125% of point-estimates from published literature.
Cost-effectiveness of PCV13 in immunocompetent US adults aged 65 years varies considerably under alternative assumptions regarding VE-PCV13 versus ST3. When assuming a reasonable value for VE-PCV13 versus ST3, results suggest that PCV13 provides acceptable value for money in this patient population.