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- W2165888476 abstract "Streptococcus pneumoniaeis a leading cause of life-threatening pneumococcal disease. In the UK, PPV23 is recommended in the elderly (aged 65 and over) and at-risk adults. In 2007, PCV was introduced in children, leading to a decrease in invasive pneumococcal disease (IPD) incidence associated with the PCV serotypes not only in vaccinated children but also in unvaccinated adults. The use of PCV13 in adults is currently under consideration pending data on efficacy in this population. This study assessed the CE of PPV23 vs. PCV13 or NoVac in the UK, accounting for epidemiological changes. An existing population-based Markov model was adapted to the UK. Five health states were considered: no IPD, IPD, NBPP (non-bacteraemic pneumococcal pneumonia), post-meningitis sequelae and death. Epidemiology and costs were estimated from UK sources. The analysis tracked one cohort of individuals assuming PPV23, PCV13 or NoVac from 2012 until death. Costs and QALYs were discounted at 3.5%. Over lifetime, vaccinating the cohort with PPV23 avoided 226 (vs. PCV13) to 337 (vs. NoVac) IPD cases. Vaccinating with PPV23 resulted in an increment of 337 (vs. PCV13) to 631 (vs. NoVac) QALYs. PPV23 was associated with savings of approximately £21 million vs. PCV13 whereas it was associated with an incremental cost of approximately £9 million vs. NoVac. PPV23 dominated PCV13 from both the third-party payer (TPP) and the societal perspectives. When compared to NoVac, the incremental CE ratio (ICER) was estimated at £14,813 and £13,497/QALY gained, from the TPP and the societal perspective, respectively. The model suggests that vaccinating with PPV23 is cost-effective when compared to both PCV13 and NoVac. As PPV23 covers 80%-90% of all serotypes causing IPD, it is still cost-effective despite the recent reduction in IPD incidence in adults. The assumptions around the efficacy of PCV13 are a substantial source of uncertainty." @default.
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- W2165888476 date "2012-11-01" @default.
- W2165888476 modified "2023-10-18" @default.
- W2165888476 title "PIN64 Assessing the Cost-Effectiveness (CE) of Vaccinating the Elderly and at-Risk Adults With the 23-Valent Pneumococcal Polysaccharide Vaccine (PPV23) Compared to the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) or no Vaccination (NoVac) in the UK" @default.
- W2165888476 doi "https://doi.org/10.1016/j.jval.2012.08.1131" @default.
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