Yi Zinan, Johnson Kelly D, Owusu-Edusei Kwame
Biostatistics & Research Decision Sciences (BARDS), Merck & Co., Inc., Rahway, NJ, USA.
Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, USA.
Infect Dis Ther. 2024 Jul;13(7):1501-1514. doi: 10.1007/s40121-024-00988-1. Epub 2024 May 25.
This study aimed to estimate and compare the lifetime clinical and economic burden of invasive pneumococcal diseases (IPD) attributable to the serotypes contained in a new 21-valent pneumococcal conjugate vaccine (V116) vs. the 20-valent pneumococcal conjugate vaccine (PCV20) among adults aged 18 years and above in the USA.
A state-transition Markov model was used to track IPD cases and deaths as well as the associated direct medical costs (in 2023 US dollars) from a US healthcare payer perspective at 3% annual discount rate. The results were summarized for V116, PCV20, and eight unique serotypes contained in V116. A sensitivity analysis was conducted to determine the most influential inputs on the overall total direct lifetime cost.
For the total population of US adults aged 18 years and above in 2021 (approx. 258 million residents), the estimated lifetime numbers of cases of IPD, post-meningitis sequelae (PMS), and IPD-related deaths attributable to the serotypes contained in V116 were approximately 1.4 million, 17,608, and 186,200, respectively, with a total discounted lifetime direct cost of $32.6 billion. A substantial proportion (approx. 31%) of those were attributable to the unique eight serotypes. The corresponding estimates for PCV20 were approximately 35% lower-934,000, 11,500, and 120,000, respectively-with a total discounted direct lifetime cost of $21.9 billion.
These results show that V116 serotypes (compared to PCV20) are associated with substantially higher clinical and economic burden of IPD. The addition of V116 to vaccination recommendations can help to reduce the residual burden of IPD in US adults.
本研究旨在评估和比较一种新型21价肺炎球菌结合疫苗(V116)与20价肺炎球菌结合疫苗(PCV20)所含血清型在美国18岁及以上成年人中引起的侵袭性肺炎球菌疾病(IPD)的终生临床和经济负担。
采用状态转换马尔可夫模型,从美国医疗保健支付方的角度,以3%的年贴现率跟踪IPD病例和死亡情况以及相关直接医疗费用(以2023年美元计)。总结了V116、PCV20以及V116中包含的8种独特血清型的结果。进行了敏感性分析,以确定对总体终生直接成本影响最大的因素。
对于2021年美国18岁及以上的成年总人口(约2.58亿居民),V116所含血清型导致的IPD病例、脑膜炎后遗症(PMS)和IPD相关死亡的终生估计数分别约为140万、17608例和186200例,终生贴现直接成本总计326亿美元。其中很大一部分(约31%)归因于8种独特血清型。PCV20的相应估计数分别低约35%,即93.4万、11500例和120000例,终生贴现直接成本总计219亿美元。
这些结果表明,V116血清型(与PCV20相比)与IPD的临床和经济负担显著更高有关。将V116纳入疫苗接种建议有助于减轻美国成年人IPD的残余负担。