Evaluating the Potential Health and Economic Impact of V116 vs. PCV20 on Invasive Pneumococcal Disease Among Adults in the United Kingdom
Author(s)
Peter P. Mueller, PhD1, Ian Matthews, BSc, MSc, PhD2, Zinan Yi, PhD3, Kelly D. Johnson, PhD4, Nicole Cossrow, MPH, PhD5, Kwame Owusu-Edusei, PhD6.
1Assoc Prin Scientist, Merck & Co., Inc., Boston, MA, USA, 2MSD (UK) Ltd, London, United Kingdom, 3Merck & Co., Inc., Rahway, NJ, USA, 4Merck & Co., Inc., Philadelphia, PA, USA, 5Merck & Co., Inc., Jenkintown, PA, USA, 6Merck & Co., Inc., West Point, PA, USA.
1Assoc Prin Scientist, Merck & Co., Inc., Boston, MA, USA, 2MSD (UK) Ltd, London, United Kingdom, 3Merck & Co., Inc., Rahway, NJ, USA, 4Merck & Co., Inc., Philadelphia, PA, USA, 5Merck & Co., Inc., Jenkintown, PA, USA, 6Merck & Co., Inc., West Point, PA, USA.
OBJECTIVES: The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is currently given to adults in the UK. We are likely to see the 20-valent pneumococcal conjugate vaccine (PCV20) be introduced, and potentially the new 21-valent PCV later (V116). Our analysis compares the health and economic impact of PPSV23, PCV20, and V116 - for the current age-based recommendation of ages 65 and older (65+). Additionally, we consider the impact of adjusting the recommendation from 65+ to 75+.
METHODS: A previously published Markov model [1] was adapted to UK data to estimate the health and economic impacts of V116 and PCV20, compared to the current programme of PPSV23. A multi-cohort of vaccine-naïve adults 65+ were simulated until a maximum age of 100, using vaccination uptake rates (Table 1) [2]. Health and economic outcomes (in 2023 pounds) were discounted at an annual rate of 3.5%.
RESULTS: The PPSV23 vaccination strategy resulted in 35,975 cases, 6,894 deaths, and £307 million direct medical costs from IPD. Compared to PPSV23, PCV20 would additionally prevent 34 cases, 5 deaths, and save £292 thousand in medical costs. Compared to PCV20, V116 would additionally prevent 155 cases, 22 deaths, and save £1.3 million in medical costs (Table 2).
For PCV20, changing the age-based recommendation from 65+ to 75+ would cause an additional 108 cases, 5 deaths, and £920 thousand medical costs from IPD. Comparing V116 for ages 65+ vs 75+, we would see an additional 164 cases, 7 deaths, and £1.4 million medical costs from IPD (Table 3).
CONCLUSIONS: When compared to the status quo of PPSV23, V116 would prevent significantly more IPD cases, deaths, and direct medical costs than PCV20. The complex interactions with life-expectancy, waning vaccine efficacy, as well as IPD incidence and mortality rates increasing with age, changing the age-based recommendation from 65 to 75 results in worse outcomes.
METHODS: A previously published Markov model [1] was adapted to UK data to estimate the health and economic impacts of V116 and PCV20, compared to the current programme of PPSV23. A multi-cohort of vaccine-naïve adults 65+ were simulated until a maximum age of 100, using vaccination uptake rates (Table 1) [2]. Health and economic outcomes (in 2023 pounds) were discounted at an annual rate of 3.5%.
RESULTS: The PPSV23 vaccination strategy resulted in 35,975 cases, 6,894 deaths, and £307 million direct medical costs from IPD. Compared to PPSV23, PCV20 would additionally prevent 34 cases, 5 deaths, and save £292 thousand in medical costs. Compared to PCV20, V116 would additionally prevent 155 cases, 22 deaths, and save £1.3 million in medical costs (Table 2).
For PCV20, changing the age-based recommendation from 65+ to 75+ would cause an additional 108 cases, 5 deaths, and £920 thousand medical costs from IPD. Comparing V116 for ages 65+ vs 75+, we would see an additional 164 cases, 7 deaths, and £1.4 million medical costs from IPD (Table 3).
CONCLUSIONS: When compared to the status quo of PPSV23, V116 would prevent significantly more IPD cases, deaths, and direct medical costs than PCV20. The complex interactions with life-expectancy, waning vaccine efficacy, as well as IPD incidence and mortality rates increasing with age, changing the age-based recommendation from 65 to 75 results in worse outcomes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH93
Topic
Epidemiology & Public Health, Health Technology Assessment, Methodological & Statistical Research
Topic Subcategory
Public Health
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines