OBJECTIVES

: Vaccination with pneumococcal polysaccharide vaccine 23 (PPSV23) alone and as shared clinical decision in combination with pneumococcal conjugate vaccine 13 (PCV13) is currently recommended for 65+ year-olds in the United States (US). Newly developed vaccines could soon be recommended for this population. The aim of this study was to determine the budgetary impact from a US perspective of switching from the current vaccination strategy to strategies that include V114 and PCV20.

METHODS

: An Excel-based cohort budget impact model with a 5-year time horizon was developed. The target population were 65+ year-olds in the US divided into low-risk, at-risk, and high-risk immunosuppressed subgroups. The payer perspective included vaccine acquisition and administration costs; non-medical costs; and treatment cost for invasive pneumococcal disease, and inpatient and outpatient non-bacteremic pneumococcal disease (NBPP). The budget impact was calculated by comparing the direct costs in a current market where people receive PPSV23, alone or in combination with PCV13, versus a future market share scenario, in which market shares of PCV20 and V114 increased to respectively 55% and 15% after 5 years, while PPSV23 retained 30% of the market.

RESULTS

: The direct costs for the current market were $19.97 billion over a 5-year time horizon. In the future market share scenario, cost savings were realized for vaccine administration, and in year 5 for NBPP inpatient treatment. Overall, costs increased with an average of $305.55 million (1.53%) per year to a total budget impact of +$1.53 billion (+7.65%) after 5 years, which were mainly explained by the relatively high vaccine costs of PCV20.

CONCLUSIONS

: The introduction of V114 and PCV20 in the US’s immunization program for 65+ year-olds reduces vaccine administration costs and could reduce long-term NBPP treatment costs. Overall costs increase mainly due to vaccine costs of PCV20.