of Antwerp, Antwerp, Belgium; bBelgian Health Care Knowledge Centre (KCE), ... Using three different vaccine efficacy scenarios regarding non-invasive pneumococcal .... based on low PPV23 vaccination coverage in the elderly with vari-.
HUMAN VACCINES & IMMUNOTHERAPEUTICS 2018, VOL. 14, NO. 5, 1218–1229 https://doi.org/10.1080/21645515.2018.1428507
RESEARCH PAPER
Economic evaluation of pneumococcal vaccines for adults aged over 50 years in Belgium Lander Willema, Adriaan Blommaerta, Germaine Hanquetb, Nancy Thiryb, Joke Bilckea, Heidi Theetenc, Jan Verhaegend, Herman Goossense, and Philippe Beutelsa,f a Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; bBelgian Health Care Knowledge Centre (KCE), Brussels, Belgium; cCenter for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; dDepartment of Clinical Microbiology, Universitair Ziekenhuis Leuven, Leuven, Belgium; eLaboratory of Medical Microbiology (LMM), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; fSchool of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
ABSTRACT
Streptococcus pneumoniae causes a high disease burden including pneumonia, meningitis and septicemia. Both a polysaccharide vaccine targeting 23 serotypes (PPV23) and a 13-valent conjugate vaccine (PCV13) are indicated for persons aged over 50 years. We developed and parameterized a static multi-cohort model to estimate the incremental cost-effectiveness and budget-impact of these vaccines at different uptake levels. Using three different vaccine efficacy scenarios regarding non-invasive pneumococcal pneumonia and extensive uni- and multivariate sensitivity analyses, we found a strong preference for PPV23 over PCV13 in all age groups at willingness to pay levels below €300 000 per quality adjusted life year (QALY). PPV23 vaccination would cost on average about €83 000, €60 000 and €52 000 per QALY gained in 50–64, 65–74 and 75–84 year olds, whereas for PCV13 this is about €171 000, €201 000 and €338 000, respectively. Strategies combining PPV23 and PCV13 vaccines were most effective but generally less cost-effective. When assuming a combination of increased duration of PCV13 protection, increased disease burden preventable by PCV13 and a 75% reduction of the PCV13 price, PCV13 could become more attractive in
