Meta-analysis of Economic Evaluations of Higher-Valent Pneumococcal Conjugate Vaccines For Seniors in High-Income Countries
Author(s)
Haeseon Lee, PharmD, MS1, Jeong-Yeon Cho, PharmD, PhD1, Euan Dawson, MSc2, Jeffrey Vietri, BA, MS, PhD2, Nathorn Chaiyakunapruk, PharmD, PhD1;
1University of Utah, Salt Lake City, UT, USA, 2Pfizer, Inc., Collegeville, PA, USA
1University of Utah, Salt Lake City, UT, USA, 2Pfizer, Inc., Collegeville, PA, USA
OBJECTIVES: Numerous economic evaluations of higher-valent pneumococcal conjugate vaccines (PCVs) have been conducted since the approval of 15- and 20-valent PCVs for adults in 2021. A recent systematic review qualitatively summarized these evaluations without integrating them quantitatively, which may benefit decision-makers. This study performs a meta-analysis of economic evaluations using incremental net benefit (INB) estimates from available studies on higher-valent PCVs in older adults.
METHODS: Studies reporting cost-effectiveness of PCV15 or PCV20 were identified through database searches (PubMed, EMBASE, EconLit, Tufts CEA registry, HTA database, and NITAG resource center) through November 2024. We collected data from high-income countries focusing on senior populations aged ≥60 years. INB was calculated by multiplying the incremental effectiveness by the willingness-to-pay threshold and subtracting the incremental costs, with positive INB indicating cost-effectiveness. INB values were synthesized using a random-effects model, heterogeneity was assessed with the I² statistic, and risk of bias was evaluated using the modified ECOBIAS checklist.
RESULTS: Twelve studies were included, comprising 2 from North America, 3 from Asia, and 7 from Europe. PCV20 was significantly cost-effective compared to PCV15 followed by PPSV23 (PCV15→PPSV23) (INB 35.3; 95% CI 23.9 to 44.6, N=4), and tended to be cost-effective compared to PCV15 (N=2), PCV13 (N=1), and PPSV23 (N=4). PCV15→PPSV23 was significantly cost-effective compared to PCV13 (41.4; 16.5 to 66.3, N=1) and tended to be cost-effective compared to PCV13→PPSV23 (N=1) and PPSV23 (N=1). PCV15 was significantly cost-effective compared to PCV13 (81.8; 81.4 to 82.2, N=1) and tended to be cost-effective compared to PPSV23 (N=3).
CONCLUSIONS: This study suggests that higher-valent PCVs are generally cost-effective for the senior population in high-income countries, including PCV20 relative to PCV15. These findings can provide valuable insights for vaccination policy decisions in regions contemplating the use of higher-valent PCVs for older adults, supporting the efficient allocation of healthcare resources.
METHODS: Studies reporting cost-effectiveness of PCV15 or PCV20 were identified through database searches (PubMed, EMBASE, EconLit, Tufts CEA registry, HTA database, and NITAG resource center) through November 2024. We collected data from high-income countries focusing on senior populations aged ≥60 years. INB was calculated by multiplying the incremental effectiveness by the willingness-to-pay threshold and subtracting the incremental costs, with positive INB indicating cost-effectiveness. INB values were synthesized using a random-effects model, heterogeneity was assessed with the I² statistic, and risk of bias was evaluated using the modified ECOBIAS checklist.
RESULTS: Twelve studies were included, comprising 2 from North America, 3 from Asia, and 7 from Europe. PCV20 was significantly cost-effective compared to PCV15 followed by PPSV23 (PCV15→PPSV23) (INB 35.3; 95% CI 23.9 to 44.6, N=4), and tended to be cost-effective compared to PCV15 (N=2), PCV13 (N=1), and PPSV23 (N=4). PCV15→PPSV23 was significantly cost-effective compared to PCV13 (41.4; 16.5 to 66.3, N=1) and tended to be cost-effective compared to PCV13→PPSV23 (N=1) and PPSV23 (N=1). PCV15 was significantly cost-effective compared to PCV13 (81.8; 81.4 to 82.2, N=1) and tended to be cost-effective compared to PPSV23 (N=3).
CONCLUSIONS: This study suggests that higher-valent PCVs are generally cost-effective for the senior population in high-income countries, including PCV20 relative to PCV15. These findings can provide valuable insights for vaccination policy decisions in regions contemplating the use of higher-valent PCVs for older adults, supporting the efficient allocation of healthcare resources.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE38
Topic
Economic Evaluation
Disease
STA: Vaccines