OBJECTIVES: To evaluate the cost-utility of Vaxneuvance/V114, a 15-valent pneumococcal conjugate vaccine (PCV15) in combination with pneumococcal polysaccharide vaccine 23 (PPSV23) compared to the 13-valent pneumococcal conjugate vaccine (PCV13) in a population comprising adults ≥65 years from the Czech health system perspective.

METHODS: A developed lifetime Markov cohort model with one-year cycle length projects Quality-Adjusted Life-Years (QALYs) and costs of pneumococcal vaccines for seniors. The model health states are defined by the occurrence of pneumococcal disease, its consequences (meningitis, sepsis, pneumonia) and death. Transition between health states was determined based on the incidence specific to each serotype of the vaccine. General incidence, lethality, and the probability of complications were obtained from published literature, while the serotype distribution in the population was derived from local data. Costs were based on reimbursed lists. Utilities were derived from published literature. Costs and outcomes were discounted by 3%. Deterministic and probabilistic sensitivity analyses (PSA; 1,000 iterations) with Czech willingness-to-pay (WTP) threshold of €48,600/QALY gained were conducted to ascertain the robustness of the findings.

RESULTS: Over a lifetime horizon, PCV15+PPSV23 provides additional 659 QALYs (12,680,929 vs. 12,680,270) per Czech population of adults aged ≥65 years (2,169,109 adults) at an additional total cost of €19,676,801 (€348,783,253 vs. €329,106,452) (per the same population) compared to PCV13, yielding an incremental cost-effectiveness ratio of €29,859/QALY gained. PSA demonstrated that the probability of PCV15+PPSV23 being cost-effective is 100% at the WTP threshold; OWSA confirmed robustness of the results.

CONCLUSIONS: Based on the results of the cost-utility analysis, we can state that PCV15+PPSV23 may represent a cost-effective vaccination strategy for adults aged ≥65 years in the Czech Republic. This analysis is part of a Czech pilot project requested by the Ministry of Health to test and examine the implementation of HTA for vaccines since vaccines are currently not subject to HTA in the Czech Republic.