OBJECTIVES: This study aimed to provide an overview of health-related utilities associated with pneumococcal disease (PD) in adults, based on cost-effectiveness analyses (CEAs) of pneumococcal vaccines in the United Sates (US).

METHODS: A targeted literature review (TLR) was conducted in 2023 to identify full-text US CEAs of adult pneumococcal vaccines that reported quality-adjusted life year (QALY) outcomes. Health utility inputs from these CEAs were extracted, and the original studies upon which the inputs were estimated were reviewed.

RESULTS: The TLR identified a total of 27 CEAs published between 1997 and 2022, which used either QALY decrements or utility weights combined with duration of illness as model inputs. A utility weight of 0.2 and duration-of-illness of 34 days (equivalent to a QALY decrement of 0.0745) were applied to invasive PD (IPD) and/or inpatient pneumonia in 20 CEAs. For other CEAs, QALY decrements ranging from 0.0051–0.0195 were applied for one episode of IPD and 0.003–0.006 for inpatient pneumonia. The range of QALY decrement inputs for outpatient pneumonia was 0.0014-0.004. It is worth noting that 23 CEAs cited other CEAs as sources for these inputs, which ultimately tracked back to three original utility studies published in 1993–2000. However, none of the original studies specifically evaluated utilities associated with PD in adults. One study valued health-related quality-of-life by considering activity limitations and perceived health from the National Health Interview Survey, another estimated the utility values for chronic medical conditions (e.g., chronic bronchitis), and the third study assessed parents’ preference for outcomes from treatment of occult bacteremia in young children.

CONCLUSIONS: Utility inputs in the published US CEAs varied widely and were estimated from a limited number of original studies, which did not provide utilities of the target populations or diseases. A significant research gap exists regarding health utilities of PD in the US adult population.