Impact of Real-World Effectiveness vs. Previous Assumptions on Estimates of Economic and Clinical Benefit of 20-Valent Pneumococcal Conjugate Vaccine in Adults Across Countries
Author(s)
Euan Dawson, MSc1, Jeffrey Vietri, BA, MS, PhD2, Liping Huang, MD, MA, MS3, Mark Rozenbaum, MBA, PhD4.
1Pfizer Ltd, Tadworth, United Kingdom, 2Pfizer Inc., Collegeville, PA, USA, 3Pfizer Inc., Washington Crossing, PA, USA, 4Pfizer, Capelle aan den IJssel, Netherlands.
1Pfizer Ltd, Tadworth, United Kingdom, 2Pfizer Inc., Collegeville, PA, USA, 3Pfizer Inc., Washington Crossing, PA, USA, 4Pfizer, Capelle aan den IJssel, Netherlands.
OBJECTIVES: Higher-valent pneumococcal conjugate vaccines (PCVs) for adults were licensed based on immunogenicity and safety as trials against disease endpoints were not feasible. Consequently, economic evaluations have relied on efficacy estimates from 13-valent pneumococcal conjugate vaccine (PCV13) adjusted for estimated serotype coverage. However, initial data on real-world effectiveness of 20-valent PCV (PCV20) against all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD) among older adults in the United States (US) have recently been presented. This study explores the impact of using real-world vaccine effectiveness (VE) estimates of PCV20 relative to previous effectiveness assumptions in economic models of PCV20 use in adults.
METHODS: Published cost-effectiveness models evaluating PCV20 in adults in a variety of countries were replicated and adapted to incorporate PCV20 VE as observed in a recent study of adults aged ≥65 years in the US. All other model inputs (e.g., vaccine uptake, waning, disease incidence, serotype distribution, associated costs) were retained from the base case of the original models as described in their respective publications. Cases of disease, disease-related deaths, direct medical costs, and quality-adjusted life-years were projected using PCV20 real-world effectiveness estimates and compared to results generated using the original base-case effectiveness assumptions.
RESULTS: Use of real-world PCV20 effectiveness estimates reduced the total number of hospitalizations due to disease, disease-associated deaths, and medical costs, and increased quality-adjusted life-years across markets. The magnitude of the difference varied across countries, in part due to differences in population size, uptake rate, and time horizon.
CONCLUSIONS: Using PCV20 VE derived from real-world evidence predicts greater economic and clinical benefits compared to previous VE estimates used in economic models, suggesting existing economic models evaluating PCV20 in adults are likely conservative. Vaccine policy makers should incorporate available real-world effectiveness data when considering higher-valent PCVs for adults.
METHODS: Published cost-effectiveness models evaluating PCV20 in adults in a variety of countries were replicated and adapted to incorporate PCV20 VE as observed in a recent study of adults aged ≥65 years in the US. All other model inputs (e.g., vaccine uptake, waning, disease incidence, serotype distribution, associated costs) were retained from the base case of the original models as described in their respective publications. Cases of disease, disease-related deaths, direct medical costs, and quality-adjusted life-years were projected using PCV20 real-world effectiveness estimates and compared to results generated using the original base-case effectiveness assumptions.
RESULTS: Use of real-world PCV20 effectiveness estimates reduced the total number of hospitalizations due to disease, disease-associated deaths, and medical costs, and increased quality-adjusted life-years across markets. The magnitude of the difference varied across countries, in part due to differences in population size, uptake rate, and time horizon.
CONCLUSIONS: Using PCV20 VE derived from real-world evidence predicts greater economic and clinical benefits compared to previous VE estimates used in economic models, suggesting existing economic models evaluating PCV20 in adults are likely conservative. Vaccine policy makers should incorporate available real-world effectiveness data when considering higher-valent PCVs for adults.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE541
Topic
Clinical Outcomes, Economic Evaluation, Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Vaccines