Health Economics, SNB management, Soignies, Belgium.
Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons-UMONS, Mons, Belgium.
Expert Rev Vaccines. 2023 Jan-Dec;22(1):1008-1021. doi: 10.1080/14760584.2023.2273892. Epub 2023 Nov 2.
The Belgian Superior Health Council (SHC) preferentially recommended the 20-valent pneumococcal conjugate vaccine (PCV20) for adults aged ≥65 years, immunocompromised patients, and patients aged ≥50 years suffering from conditions that increase their risk for pneumococcal infections. The objective of this paper is to present the cost-utility of PCV20 compared to no vaccination and the alternative sequence of PCV15 followed by the 23-valent pneumococcal polysaccharide vaccine (PPV23) in this population.
The analysis employed a static Markov model capturing lifetime risk of pneumococcal infections, associated disutility, mortality, and costs from different healthcare payer perspectives.
Results indicated use of PCV20 among Belgian older and at-risk adults is highly cost-effective compared to no vaccination, with an incremental cost per quality-adjusted life-year (QALY) of €4,164. Compared to the sequential regimen (PCV15+PPV23), PCV20 vaccination is a cost-saving strategy. Subgroup analysis indicated PCV20 vaccination of at-risk adults aged 65-84 years would also be cost-saving from the national healthcare perspective.
Based on current knowledge, this analysis suggests that access to PCV20 should be proposed in all adults recommended for vaccination by the SHC as PCV20 prevents additional hospitalizations and deaths caused by pneumococcal infection at an affordable cost.
比利时高级卫生理事会（SHC）优先推荐 20 价肺炎球菌结合疫苗（PCV20）用于≥65 岁的成年人、免疫功能低下的患者以及≥50 岁患有增加肺炎球菌感染风险的疾病的患者。本文旨在比较 PCV20 与不接种疫苗以及 PCV15 序贯接种后再接种 23 价肺炎球菌多糖疫苗（PPV23）在该人群中的成本效用。
分析采用静态马尔可夫模型，从不同医疗支付者的角度捕捉终生肺炎球菌感染风险、相关不舒适、死亡率和成本。
结果表明，与不接种疫苗相比，PCV20 在比利时老年和高危成年人中使用具有高度成本效益，每增加一个质量调整生命年（QALY）的增量成本为 4164 欧元。与序贯方案（PCV15+PPV23）相比，PCV20 接种是一种节省成本的策略。亚组分析表明，从国家医疗保健的角度来看，为 65-84 岁的高危成年人接种 PCV20 也是节省成本的。
基于目前的知识，这项分析表明，对于 SHC 推荐接种疫苗的所有成年人，应提供 PCV20 的接种机会，因为 PCV20 可以以可负担的成本预防肺炎球菌感染引起的额外住院和死亡。
