From a social and economic standpoint, the burden of pneumococcal illness in adults is significant. This study compared the cost-effectiveness of the 13-valent pneumococcal conjugate vaccine (PCV13) with “no vaccination” and immunisation with the 23-valent pneumococcal polysaccharide vaccine for the prevention of invasive pneumococcal illness and pneumococcal pneumonia in adults (PPSV23). A Markov model was utilised to simulate three strategies: no vaccination, full PPSV23 vaccination, and full PCV13 vaccination. The model considered the age, risk profile, vaccination status, type of immunisation, and time since vaccination distributions in the population. A societal viewpoint was taken into account, as well as a lifelong horizon. PPSV23 and PCV13 efficacy were calibrated using a variety of data sources and assumptions. The 2013 diagnosis-related group (DRG) database for National Health Service (NHS) hospitals and expert opinion were used to calculate inpatient prices; NHS official tariffs were the primary source for unitary charges. PCV13 had ICURs of €17,746/QALY vs “no vaccination” and €13,146/QALY versus PPSV23 immunisation, respectively.

In univariate sensitivity analysis, all ratios were less than a €20,000 threshold, with the exception of the scenario in which PCV13 efficacy was half. In all techniques, 94 percent of simulations had cost-effectiveness ratios less than €20,000/QALY, according to a probabilistic sensitivity analysis. PCV13 was discovered to be a cost-effective approach for preventing pneumococcal illness in adults in Portugal.

Reference:https://www.tandfonline.com/doi/full/10.1080/21645515.2018.1560769