OBJECTIVES:

Pneumococcal disease is a major cause of morbidity and mortality worldwide, especially in children under 5 and elderly persons aged 65 and above. Since 2010, the 13-valent conjugated vaccine PCV13 has been part of the Danish Childhood Vaccination Programme (DVCP). MSD has developed a 15-valent pneumococcal conjugate vaccine, PCV15, which contains serotypes 22F and 33F in addition to the 13 serotypes included in PCV13. It is estimated that serotypes 22F and 33F account for 9.5%, 12.3% and 16% of the serotype distributions in the age groups 0–4, 5–65 and +65, respectively.

The study aimed to estimate the health economic outcomes associated with the added coverage of PCV15 compared to PCV13 in the DVCP.

METHODS:

A Markov model was adapted to a Danish healthcare setting to simulate the incidence, costs and mortality of non-bacteremic pneumococcal pneumonia (NBPP), invasive pneumococcal disease (IPD), acute otitis media (AOM) and post-meningitis sequelae (PMS) in the Danish population over a time horizon of 100 years.

A similar vaccine-type efficacy and waning profile was assumed for both vaccines. In addition, it was assumed that PCV15 would reduce the prevalence of serotypes 23F and 33F by 33.4% within five years of introduction.

RESULTS:

Replacing PCV13 with PCV15 in the DVCP would prevent 607 IPD cases, 916 NBPP cases, 11,980 AOM cases and 14 PMS cases per 10,000 persons in a vaccination cohort. Furthermore, PCV15 would prevent 89 IPD-related deaths and result in savings of more than EUR 25.8 million over a time horizon of 100 years.

CONCLUSIONS:

Overall, PCV15 was strongly dominant compared to PCV13. The findings therefore suggest that including PCV15 in the DVCP can prevent a significant number of pneumococcal cases and deaths and reduce pneumococcal disease-related costs.