Health Utilities Associated With Pneumococcal Diseases in Children and Adults in the United States: A Targeted Literature Review and Meta-Analysis
Author(s)
Min Huang, PhD1, Hela Romdhani, PhD2, Yan Song, PhD3, Jipan Xie, PhD4, Daisy Liu, MS3, Donna Rowen, PhD5, Elamin Elbasha, PhD1, Salini Mohanty, DrPH1, Matthew S. Kelly, MD, MPH6.
1Merck & Co., Inc., Rahway, NJ, USA, 2Analysis Group, Inc., Montréal, QC, Canada, 3Analysis Group, Inc., Boston, MA, USA, 4XL Source, Inc., Los Angeles, CA, USA, 5Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, United Kingdom, 6Division of Pediatric Infectious Diseases, Duke University, Durham, NC, USA.
1Merck & Co., Inc., Rahway, NJ, USA, 2Analysis Group, Inc., Montréal, QC, Canada, 3Analysis Group, Inc., Boston, MA, USA, 4XL Source, Inc., Los Angeles, CA, USA, 5Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, United Kingdom, 6Division of Pediatric Infectious Diseases, Duke University, Durham, NC, USA.
Presentation Documents
OBJECTIVES: Pneumococcal disease (PD) and post-meningitis sequelae (PMS) significantly affect health-related quality of life (HRQoL). This study presents meta-analyses of utility estimates for PD and PMS in children and adults in the United States (US).
METHODS: A targeted literature review was conducted in June 2024 to identify original US studies reporting health utility values for PD and PMS. For PD, utility values and quality-adjusted life years (QALYs) were converted to QALY decrements per episode based on the illness duration. Meta-analyses were conducted to derive pooled QALY decrement estimates for each PD state and pooled utility estimates for PMS, provided that ≥2 studies were available for analysis.
RESULTS: Ten original utility studies published between 1993 and 2009 were identified, of which 7 were included in the meta-analyses (3 excluded due to the requirement of ≥2 studies per disease state). Most studies employed direct utility estimation methods, including standard gamble (2), time trade-off (2), and visual analogue scale (1). In children, QALY decrement estimates per episode were 0.022 (95% CI: 0.012, 0.032) for meningitis, 0.007 (0.002, 0.011) for bacteremia, and 0.0004 (0.0000, 0.0023) for acute otitis media; health utility estimates of PMS were 0.829 (0.702, 0.955) for hearing loss and 0.582 (0.386, 0.778) for neurological deficits. In adults, QALY decrement estimates per episode were 0.007 (0.006, 0.009) for inpatient pneumonia and 0.006 (0.004, 0.008) for outpatient pneumonia; the health utility estimate for neurological deficits was 0.470 (0.312, 0.629). Insufficient data were identified for pneumonia in children, and meningitis, bacteremia, and hearing loss in adults.
CONCLUSIONS: PD and PMS significantly impair HRQoL in children and adults. However, few studies estimated utility values for these health states in the US, and none have been published within the past 15 years. More recent data is needed to better understand the current burden in the US.
METHODS: A targeted literature review was conducted in June 2024 to identify original US studies reporting health utility values for PD and PMS. For PD, utility values and quality-adjusted life years (QALYs) were converted to QALY decrements per episode based on the illness duration. Meta-analyses were conducted to derive pooled QALY decrement estimates for each PD state and pooled utility estimates for PMS, provided that ≥2 studies were available for analysis.
RESULTS: Ten original utility studies published between 1993 and 2009 were identified, of which 7 were included in the meta-analyses (3 excluded due to the requirement of ≥2 studies per disease state). Most studies employed direct utility estimation methods, including standard gamble (2), time trade-off (2), and visual analogue scale (1). In children, QALY decrement estimates per episode were 0.022 (95% CI: 0.012, 0.032) for meningitis, 0.007 (0.002, 0.011) for bacteremia, and 0.0004 (0.0000, 0.0023) for acute otitis media; health utility estimates of PMS were 0.829 (0.702, 0.955) for hearing loss and 0.582 (0.386, 0.778) for neurological deficits. In adults, QALY decrement estimates per episode were 0.007 (0.006, 0.009) for inpatient pneumonia and 0.006 (0.004, 0.008) for outpatient pneumonia; the health utility estimate for neurological deficits was 0.470 (0.312, 0.629). Insufficient data were identified for pneumonia in children, and meningitis, bacteremia, and hearing loss in adults.
CONCLUSIONS: PD and PMS significantly impair HRQoL in children and adults. However, few studies estimated utility values for these health states in the US, and none have been published within the past 15 years. More recent data is needed to better understand the current burden in the US.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR35
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
STA: Vaccines