Zayed Mostafa, Joury Jean, Farghaly Mohamed, Al Dallal Sara, Mahboub Bassam, Kutrieb Emily, Averin Ahuva
Pfizer Gulf FZ LLC, Dubai, United Arab Emirates.
Dubai Health Authority, Dubai, United Arab Emirates.
Curr Ther Res Clin Exp. 2023 Mar 14;98:100698. doi: 10.1016/j.curtheres.2023.100698. eCollection 2023.
Dubai Health Authority currently recommends sequential administration of 13-valent pneumococcal conjugate vaccine (PCV13) followed by (→) 23-valent pneumococcal polysaccharide vaccine (PPV23) to prevent pneumococcal disease among adults at elevated risk of illness. Despite recommendations, disease burden and associated costs remain substantial. A new 20-valent pneumococcal conjugate vaccine (PCV20) recently received regulatory approval in the United Arab Emirates and has the potential to further reduce burden of pneumococcal disease.
To evaluate budget impact of use of novel PCV20 compared with current recommendations (ie, PCV13→PPV23) among expatriates in Dubai aged 50 to 99 years and those aged 19 to 49 years with risk factors.
A deterministic model depicted 5-year risks and costs of invasive pneumococcal disease and all-cause nonbacteremic pneumonia. Each year of the modeling horizon, persons could be vaccinated with either PCV20 or PCV13→PPV23 or remain unvaccinated; persons vaccinated during the modeling horizon were not eligible for vaccination in subsequent years. Annual vaccine uptake was assumed to be 5% in base cases analyses; higher uptake was considered in scenario analyses. Costs were discounted at 3.5% annually and reported in US dollars.
In base case, use of PCV20 alone would prevent an additional 13 cases of invasive pneumococcal disease, 31 cases of inpatient all-cause nonbacteremic pneumonia, 139 cases of outpatient all-cause nonbacteremic pneumonia, and 5 disease-related deaths compared with PCV13→PPV23. Medical care costs would be reduced by $354,000, and total vaccination costs would decrease by $4.4 million. PCV20 would therefore yield net budgetary impact of -$4.8 million, resulting in savings of $2.47 per-person per-year over 5 years. In scenarios with higher vaccine uptake, PCV20 prevented more cases and deaths and yielded greater budget savings (vs PCV13→PPV23).
PCV20 would reduce burden and economic costs of pneumococcal disease among expatriates in Dubai compared with PCV13→PPV23 and would therefore be budget saving for private health insurers who cover the majority of this population.
迪拜卫生局目前建议序贯接种13价肺炎球菌结合疫苗（PCV13），随后接种（→）23价肺炎球菌多糖疫苗（PPV23），以预防患病风险较高的成年人患肺炎球菌疾病。尽管有这些建议，但疾病负担和相关成本仍然很高。一种新的20价肺炎球菌结合疫苗（PCV20）最近在阿拉伯联合酋长国获得监管批准，有可能进一步减轻肺炎球菌疾病的负担。
评估在迪拜50至99岁的外籍人士以及19至49岁有风险因素的人群中，与当前建议（即PCV13→PPV23）相比，使用新型PCV20的预算影响。
一个确定性模型描述了侵袭性肺炎球菌疾病和全因非菌血症性肺炎的5年风险和成本。在建模期的每一年，人们可以接种PCV20或PCV13→PPV23，或者不接种；在建模期内接种疫苗的人在随后几年没有资格接种疫苗。在基础病例分析中，假设年度疫苗接种率为5%；在情景分析中考虑了更高的接种率。成本按每年3.5%进行贴现，并以美元报告。
在基础病例中，与PCV13→PPV23相比，单独使用PCV20可额外预防13例侵袭性肺炎球菌疾病、31例住院全因非菌血症性肺炎、139例门诊全因非菌血症性肺炎和5例与疾病相关的死亡。医疗费用将减少35.4万美元，总疫苗接种费用将减少440万美元。因此，PCV20将产生-480万美元的净预算影响，在5年内每人每年节省2.47美元。在疫苗接种率较高的情景中，PCV20预防了更多的病例和死亡，并产生了更大的预算节省（与PCV13→PPV23相比）。
与PCV13→PPV23相比，PCV20将减轻迪拜外籍人士肺炎球菌疾病的负担和经济成本，因此对于覆盖这一大多数人群的私人健康保险公司来说将节省预算。
