Presentation (CTI)

OBJECTIVES: Antimicrobial resistance (AMR) is a critical global health challenge with profound economic implications. While vaccination is a key strategy in mitigating AMR by reducing antibiotic consumption and preventing transmission of resistant infections, their role in mitigating AMR is often overlooked in health economic models. This study aims to establish a conceptual framework for a model that quantifies the impact of vaccination on AMR, using Pneumococcal Conjugate Vaccines (PCVs) as a case study.
METHODS: The framework includes three critical pathways: population and pathogen, clinical care, and health outcomes. It examines disease epidemiology, antibiotic consumption patterns, resistance emergence, and healthcare interventions specific to demographic and clinical factors. To operationalize this framework, we identify a wealth of required data, including serotype-specific incidence, case-to-carrier ratios, resistance profiles, and the probability of resistance development. Due to considerable data gaps, we implemented the framework to the extent feasible by incorporating available age- and disease-type-specific data related to antibiotic prescriptions and resistance.
RESULTS: The model evaluated the long-term impact of routine PCV20 immunization compared to PCV13 and PCV15. Over a 25-year period, PCV20 is projected to prevent an additional 23,499,871 and 12,081,247 antibiotic prescriptions and avert 14,044,492 and 7,242,440 antibiotic-resistant infections compared to PCV13 and PCV15, respectively.
CONCLUSIONS: This pragmatic modelling approach effectively demonstrates the significant potential of PCV infant immunization in reducing antibiotic prescriptions and resistance. Additionally, the framework has identified key data gaps necessary for improving future modelling efforts. These findings advocate for the inclusion of AMR into cost-effectiveness models and to incorporate AMR impact into the health technology assessment and appraisals of vaccines.