Reiko Sato, United States of America
Pfizer Inc. HEORPoster Author Of 2 e-Posters
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ATTRIBUTABLE COST OF ADULT HOSPITALIZED PNEUMONIA BEYOND THE ACUTE PHASE
COST-EFFECTIVENESS OF PCV13 IN IMMUNOCOMPETENT US ADULTS AGED 65 YEARS: IMPORTANCE OF VACCINE EFFECTIVENESS AGAINST SEROTYPE 3
Presenter of 2 Presentations
COST-EFFECTIVENESS OF PCV13 IN IMMUNOCOMPETENT US ADULTS AGED 65 YEARS: IMPORTANCE OF VACCINE EFFECTIVENESS AGAINST SEROTYPE 3 (ID 220)
Abstract
Background
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.
Methods
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.
Results
Cost per QALY gained with PCV13->PPSV23 (vs. PPSV23) ranged from $449,304 to $184,807 when varying VE-PCV13 versus ST3 from 0% to 125% of point-estimates from published literature.
Conclusions
Cost-effectiveness of PCV13 in immunocompetent US adults aged 65 years varies considerably under alternative assumptions regarding VE-PCV13 versus ST3. When assuming a reasonable value for VE-PCV13 versus ST3, results suggest that PCV13 provides acceptable value for money in this patient population.
ATTRIBUTABLE COST OF ADULT HOSPITALIZED PNEUMONIA BEYOND THE ACUTE PHASE (ID 377)
Abstract
Background
While much is known about the cost of community-acquired pneumonia (CAP) during the acute phase, little is known about the potential attributable cost of CAP thereafter.
Methods
A retrospective matched-cohort design and data from a US private healthcare claims repository were employed. In each month of accrual (01/2013 – 07/2017), adults who were hospitalized for CAP in that month (“CAP patients”) were matched (1:1, without replacement) on demographic and clinical profiles to adults who did not develop CAP in that month (“comparison patients”). All-cause healthcare utilization and expenditures (2018 US$) were tallied during the acute phase (i.e., from date of CAP hospitalization through 30 days post-discharge) as well as from the end of the acute phase to the end of the three-year follow-up period.
Results
Expenditures during the acute phase of the CAP hospitalization averaged $32,064 (vs. $1,556 for comparison patients). By the end of the 3-year follow-up period, all-cause expenditures averaged $124,035 for CAP patients versus $63,652 for comparison patients, and thus attributable costs totaled $60,383.
Conclusions
Our findings provide additional evidence that the cost of CAP requiring hospitalization is high, and that the impact of CAP extends beyond the expected time for resolution of acute inflammatory signs.
Author Of 3 Presentations
COST-EFFECTIVENESS OF PCV13 IN IMMUNOCOMPETENT US ADULTS AGED 65 YEARS: IMPORTANCE OF VACCINE EFFECTIVENESS AGAINST SEROTYPE 3 (ID 220)
Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
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 $4.2 billion.
Conclusions
Pneumococcal disease remains an unmet need in US adults despite increasing uptake with PCV13 and 23-valent polysaccharide vaccine. The seven new serotypes contribute substantially to the clinical and economic burden of pneumococcal disease in adults.
ATTRIBUTABLE COST OF ADULT HOSPITALIZED PNEUMONIA BEYOND THE ACUTE PHASE (ID 377)
Abstract
Background
While much is known about the cost of community-acquired pneumonia (CAP) during the acute phase, little is known about the potential attributable cost of CAP thereafter.
Methods
A retrospective matched-cohort design and data from a US private healthcare claims repository were employed. In each month of accrual (01/2013 – 07/2017), adults who were hospitalized for CAP in that month (“CAP patients”) were matched (1:1, without replacement) on demographic and clinical profiles to adults who did not develop CAP in that month (“comparison patients”). All-cause healthcare utilization and expenditures (2018 US$) were tallied during the acute phase (i.e., from date of CAP hospitalization through 30 days post-discharge) as well as from the end of the acute phase to the end of the three-year follow-up period.
Results
Expenditures during the acute phase of the CAP hospitalization averaged $32,064 (vs. $1,556 for comparison patients). By the end of the 3-year follow-up period, all-cause expenditures averaged $124,035 for CAP patients versus $63,652 for comparison patients, and thus attributable costs totaled $60,383.
Conclusions
Our findings provide additional evidence that the cost of CAP requiring hospitalization is high, and that the impact of CAP extends beyond the expected time for resolution of acute inflammatory signs.