Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Among Adults in the Philippines

被引:0
|
作者
Santiaguel, Joel [1 ,2 ]
Averin, Ahuva [3 ]
Nua, Winniefer [4 ]
Atwood, Mark [3 ]
Huang, Liping [5 ]
Hariharan, Dhwani [3 ]
Guerrero, Josephine [6 ]
Zotomayor, Ricardo [7 ,8 ]
David-Wang, Aileen [1 ,2 ]
机构
[1] UP Manila Coll Med, Div Pulm Med, Manila, Ermita, Philippines
[2] Philippine Gen Hosp, Manila, Ermita, Philippines
[3] Avalere Hlth, Boston, MA USA
[4] Pfizer Inc, Makati, Philippines
[5] Pfizer Inc, Collegeville, PA USA
[6] Pfizer Inc, Redwood City, CA USA
[7] UERMMMC Inc SLMC, Quezon City, Philippines
[8] SLMC, Quezon City, Philippines
关键词
adults; pneumococcal conjugate vaccine; pneumococcal disease; pneumococcal polysaccharide vaccine; pneu-; monia; Philippines; Streptococcus pneumoniae; COMMUNITY-ACQUIRED PNEUMONIA; POLYSACCHARIDE VACCINE; AGED; 65; DISEASE; OLDER; STRATEGIES; BURDEN; TRIAL; PREVENTION; ENGLAND;
D O I
10.1016/j.vhri.2025.101095
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives: The Philippine National Immunization Program guidelines recommend using the 23-valent pneumococcal polysaccharide vaccine (PPV23) among senior citizens. We conducted cost-effectiveness analyses to assess the impact of replacing 2-dose PPV23 with PCV13 in all adults aged >= 60 years and expanding the recommendation to include PCV13 for adults aged 18 to 59 years at elevated risk of disease (moderate-/high-risk). Methods: Lifetime risks and costs of invasive pneumococcal disease, nonbacteremic pneumococcal pneumonia (NBPP), and expected impact of vaccination were projected using a probabilistic cohort model. Base-case analyses compared PCV13 with 2-dose PPV23 (PPV23 + PPV23) among older adults (60-99y). Scenario analyses evaluated PCV13 use among older and moderate-/high-risk adults aged 18 to 59 years versus a combined strategy (18-49 y: no vaccine; 50-59 y: single-dose PPV23; 60-99 y: PPV23 + PPV23). Cost per quality-adjusted life year (QALY) gained was evaluated from healthcare system and societal perspectives (discounting 7%/year). Deterministic and probabilistic sensitivity analyses were conducted. Results: In the base case, PCV13 instead of PPV23 + PPV23 would reduce cases of invasive pneumococcal disease by 698, NBPP by 915, and deaths by 333 among adults aged 60 to 99 years (N = 10 583 924). With QALYs higher by 848 and net societal (ie, direct + indirect) costs of (sic)26.2 million, cost per QALY was (sic)30 855. PCV13 was cost-effective in 98.8% of 1000 probabilistic sensitivity analyses simulations in the base-case population. In scenario analyses, PCV13 was also cost-effective ((sic)423 770/ Conclusions: Findings support replacing the two-dose PPV23 recommendation with 1 dose of PCV13 in adults aged >= 60 years and expanding the recommendation to include the use of PCV13 among moderate-/high-risk adults aged 18 to 59 years.
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页数:8
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