Matt Wasserman, United States of America

Pfizer Inc. Health Economics and Outcomes Research

Presenter of 2 Presentations

SYSTEMATIC REVIEW OF ECONOMIC EVALUATIONS OF PNEUMOCOCCAL CONJUGATE VACCINES IN EAST AND SOUTHEAST ASIA (ID 241)

Abstract

Background

Pneumococcal conjugate vaccines (PCVs) reduced the incidence of pneumococcal disease. We performed a systematic literature review of the cost-effectiveness of PCVs within East and Southeast Asia.

Methods

We reviewed the MEDLINE and EMBASE databases through 10/11/2019 to identify studies evaluating the cost-effectiveness of PCVs in East and Southeast Asia. Study characteristics, clinical outcomes, cost outcomes, and cost-effectiveness results were extracted, while studies without at least one analysis in East and Southeast Asia were excluded.

Results

We included 32 studies: 3 multi-setting studies and 29 single-setting studies. Within these studies, there were a total of 55 separate analyses comparing pneumococcal vaccination strategies. A PCV (PCV7/10/13) was compared to no vaccination in 45 (81.8%) analyses, and the vaccine was considered cost-effective in 86.7% (39/45) (Table 1). PCV13 and PCV10 were evaluated in 9 (16.4%) analyses. The results comparing PCV10 with PCV13 were heavily dependent on the study funder and modeling assumptions but independent studies found PCV13 cost-effective compared to PCV10 due to broader serotype coverage.

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Conclusions

PCVs are generally cost-effective against no vaccination in Asia. This study will support decision-makers in Asia as they consider the clinical and economic value of introducing PCV NIPs and considering higher valent vaccines.

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Author Of 7 Presentations

10-YEAR PUBLIC HEALTH IMPACT FROM 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) IN LATIN AMERICA (ID 240)

Session Name
Population Sciences - Epidemiology, Economics, and Mathematical Modelling

Abstract

Background

Pneumococcal conjugate vaccine (PCV) national immunization programs (NIPs) have effectively reduced vaccine serotype pneumococcal disease (PD) morbidity and mortality across Latin America (LatAm). In 2010, the 10-valent and 13-valen PCVs were introduced in routine alimentation. Given PCV13’s broader use and serotype coverage, we quantified its impact across LatAm.

Methods

We calculated the 10-year impact of pediatric PCV13 NIPs in LatAm by estimating PD cases averted and mortality prevented. A model was used to conduct the analysis for ages <5 in 14 LatAm countries that implemented PCV13 NIPs. Data were from reports by the United Nations, World Health Organization, and World Bank for parameters where available. Results are presented by country and aggregately.

Results

Approximately 39.4 million children have been vaccinated. Pediatric PCV13 vaccination translated into 13.7 million total pneumococcal disease cases averted (Table 1). Of the cases averted, 334 thousand were invasive pneumococcal disease, 2.2 million were pneumonia, and 11.2 million were otitis media. Moreover, 49.5 thousand estimated deaths were prevented.

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Conclusions

The 10-year history of pediatric PCV13 NIPs in LatAm prevented millions of pneumococcal disease cases and thousands of deaths. However, the true public health impact is underestimated, as herd effects for non-vaccinated groups are not included in the calculations.

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ESTIMATED PNEUMOCOCCAL DISEASE AND ECONOMIC BURDEN FOR CURRENT AND FUTURE VACCINE SEROTYPES IN UNITED STATES IN CHILDREN UNDER FIVE YEARS OF AGE. (ID 288)

Abstract

Background

The 13-valent PCV (PCV13) has reduced vaccine preventable pneumococcal disease caused by serotypes 4,6B,9V,14,18C,19F,23F1,5,7F,3,6A,19A, with cross-protection against 6C. However, non-vaccine type burden remains in the United States (US). Higher-valent PCVs in development will contain additional serotypes 22F,33F,8,10A,11A,12F, and 15B (PCV20). We estimated the remaining clinical and economic burden attributed to current and future vaccine serotypes in US children under five.

Methods

The burden of invasive pneumococcal disease (IPD), pneumonia, and acute otitis media (AOM) was estimated by extrapolating the IPD serotype distribution from 2017 CDC Active Bacterial Core (ABC) surveillance data for PCV13 serotypes (25.0%) and PCV20 serotypes (58.1%) to current population statistics for all clinical entities. Clinical, epidemiologic, and costs data were sourced or estimated from published evidence.

Results

The estimated burden associated with PCV13 and PCV20 serotypes are in Table 1. Based on assumptions, the incremental burden is 700,000 disease cases and 69 deaths annually caused by additional serotypes contained in PCV20. This represented $445 million incremental annual direct costs in 2019 dollars.

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Conclusions

Future PCV serotypes encompass a considerable amount of the disease burden. US infant pneumococcal disease and healthcare expenditure may be reduced if future PCVs provide comparable levels of protection as PCV13 serotypes.

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SYSTEMATIC REVIEW OF ECONOMIC EVALUATIONS OF PNEUMOCOCCAL CONJUGATE VACCINES IN EAST AND SOUTHEAST ASIA (ID 241)

Abstract

Background

Pneumococcal conjugate vaccines (PCVs) reduced the incidence of pneumococcal disease. We performed a systematic literature review of the cost-effectiveness of PCVs within East and Southeast Asia.

Methods

We reviewed the MEDLINE and EMBASE databases through 10/11/2019 to identify studies evaluating the cost-effectiveness of PCVs in East and Southeast Asia. Study characteristics, clinical outcomes, cost outcomes, and cost-effectiveness results were extracted, while studies without at least one analysis in East and Southeast Asia were excluded.

Results

We included 32 studies: 3 multi-setting studies and 29 single-setting studies. Within these studies, there were a total of 55 separate analyses comparing pneumococcal vaccination strategies. A PCV (PCV7/10/13) was compared to no vaccination in 45 (81.8%) analyses, and the vaccine was considered cost-effective in 86.7% (39/45) (Table 1). PCV13 and PCV10 were evaluated in 9 (16.4%) analyses. The results comparing PCV10 with PCV13 were heavily dependent on the study funder and modeling assumptions but independent studies found PCV13 cost-effective compared to PCV10 due to broader serotype coverage.

table 1.png

Conclusions

PCVs are generally cost-effective against no vaccination in Asia. This study will support decision-makers in Asia as they consider the clinical and economic value of introducing PCV NIPs and considering higher valent vaccines.

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CLINICAL AND ECONOMIC BURDEN ATTRIBUTABLE TO SEROTYPES INCLUDED IN FUTURE PNEUMOCOCCAL CONJUGATE VACCINES IN CANADIAN CHILDREN UNDER FIVE YEARS OF AGE (ID 236)

Abstract

Background

In Canada, higher-valence pneumococcal conjugate vaccines (PCV10, PCV13) were introduced into the routine pediatric programs in 2009/2010. Despite their impact, there remains substantial disease burden. PCVs inclusive of up to 20 serotypes (PCV20), currently in development, are expected to considerably expand pneumococcal disease coverage. Our objective was to estimate the clinical and economic burden caused by PCV20 serotypes among Canadian children under five years.

Methods

Epidemiologic, clinical, and cost data were derived or estimated from published sources (Table 1). Cases (invasive pneumococcal disease (IPD), pneumonia, acute otitis media (AOM)), mortality, and direct costs caused by PCV20 serotypes were calculated for children under 5 based on 2017 population figures and assuming IPD serotype distribution for all clinical entities.

Results

Results are summarized in Table 1. Based on our assumptions, PCV20 serotypes were estimated to cover 52% of pneumococcal disease, or a total of 102,036 annual cases. Of these, IPD represented an estimated 0.13%. Total direct attributable costs were 27 million CAD. isppd canada boi table 1.png

Conclusions

Substantial amount of morbidity from pneumococcal disease, of which IPD represents only a small proportion, could be potentially addressed by the next generation PCVs currently in development.

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CURRENT AND FUTURE PNEUMOCOCCAL CONJUGATE VACCINE SEROTYPE-SPECIFIC BURDEN IN THE UNITED STATES ADULT POPULATION (ID 287)

Abstract

Background

An investigational 20-valent pneumococcal conjugate vaccine (PCV20) is in development and contains the 13 serotypes in PCV13, with 7 additional serotypes 22F,33F,8,10A,11A,12F and 15B. We estimated the epidemiologic and economic burden of pneumococcal disease attributable to serotypes contained in PCV13 and PCV20 for US adults.

Methods

The burden of disease was estimated using published and unpublished data on incidence rates, serotype coverage, mortality, and costs for invasive pneumococcal disease (IPD) and pneumonia. Active Bacterial Core surveillance data from 2017 was used for IPD data. Data was extrapolated to the total US adult population, stratified by age and risk group.

Results

Results are summarized in Table. An additional 9,900 cases of IPD, 44,000 cases of inpatient pneumonia, 52,000 cases of outpatient pneumonia, and 4,300 death are estimated to be caused by the seven new serotypes in PCV20. The new serotypes account for approximately 40% of all cases, deaths, and costs. Direct costs attributed to all PCV20 serotypes are estimated at $4.2 billion.

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Conclusions

Pneumococcal disease remains an unmet need in US adults despite increasing uptake with PCV13 and 23-valent polysaccharide vaccine. The seven new serotypes contribute substantially to the clinical and economic burden of pneumococcal disease in adults.

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