Cost-effectiveness analyses of 15- and 20-valent pneumococcal conjugate vaccines for Japanese elderly

Shu-Ling Hoshi; Aiko Shono; Xerxes Seposo; Reiko Okubo; Masahide Kondo

doi:10.1016/j.vaccine.2022.10.010

Cost-effectiveness analyses of 15- and 20-valent pneumococcal conjugate vaccines for Japanese elderly

Vaccine. 2022 Nov 22;40(49):7057-7064. doi: 10.1016/j.vaccine.2022.10.010. Epub 2022 Oct 21.

Authors

Shu-Ling Hoshi¹, Aiko Shono², Xerxes Seposo³, Reiko Okubo⁴, Masahide Kondo¹

Affiliations

¹ Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577, Japan.
² Laboratory of Social Pharmacy and Regulatory Science, Showa Pharmaceutical University, Machida, Tokyo 194-8543, Japan. Electronic address: shono@ac.shoyaku.ac.jp.
³ Department of Hygiene, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan.
⁴ Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577, Japan; Department of Clinical Laboratory Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.

PMID: 36273987
DOI: 10.1016/j.vaccine.2022.10.010

Abstract

Background: Despite the 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination programme implementation, pneumococcal disease (PD) remains an important cause of morbidity and mortality among the elderly in Japan, particularly since childhood pneumococcal conjugate vaccine (PCV) vaccination programme continues to alter the serotype PD distribution among the elderly. Recently, in the United States, PCV15/PCV20 were recommended for adults aged ≥ 65 years and those aged 19-64 years with certain underlying conditions. In Japan, PCV15 is under the approval application process and PCV20 undergoing clinical trials, which has warranted the need in evaluating their value for money.

Methods: We conducted cost-effectiveness analyses with Markov model and calculated incremental cost-effectiveness ratios of PCV15/PCV20 vaccination programme compared to status quo from payers' perspective. Transition probabilities and utility weights in estimating quality-adjusted life-year (QALY), and disease treatment costs were either estimated or obtained from literature. To reflect the situation of COVID-19 pandemic, epidemiological data from 2020 and beyond were used.

Results: Compared to the current vaccination programme, PCV20 vaccination programme gained more QALYs with less cost, while PCV15 vaccination programme cost ¥35,020 (US$318, US$1 = ¥110) to gain an additional QALY. Replacing PPSV23 vaccination programme with PCV20 vaccination programme is cost-saving. One-way sensitivity analyses revealed that lower VE limits of PCVs against non-bacteremic pneumonia (NBP) have large impact to change the result from PCV20 vaccination programme dominated PPSV23 vaccination programme to PPSV23 vaccination programme dominated PCV20 vaccination programme.

Conclusion: In the COVID-19 era, replacing current PPSV23 with a single-dose PCV15- or PCV20 immunisation programme for 65-year-old adults in Japan is highly cost-effective, while the PCV 20 vaccination programme was observed to be more favourable.

Keywords: 23-valent pneumococcal polysaccharide vaccine; Cost-effectiveness; Economic evaluation; Pneumococcal conjugate vaccine; Quality-adjusted life year; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
COVID-19*
Child
Cost-Benefit Analysis
Humans
Japan / epidemiology
Pandemics
Pneumococcal Infections* / epidemiology
Pneumococcal Infections* / prevention & control
Pneumococcal Vaccines
Vaccination
Vaccines, Conjugate

Substances

Vaccines, Conjugate
Pneumococcal Vaccines