20. Cost-Effectiveness of Implementing 13-Valent Pneumococcal Conjugate Vaccine (Pcv13) for Adults Aged ≥19 Years with Underlying Conditions. (31st December 2020)

• Record Type: Journal Article
• Authors: Kobayashi, Miwako; Stoecker, Charles; Xing, Wei; Cho, Bo-Hyun; Pilishvili, Tamara
• Is Part Of: Open forum infectious diseases. Volume 7:Number 1(2020) Supplement
• Page Start: S33
• Page End: S33
• Publication Date: 2020-12-31
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa439.065
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: In June 2019, the U.S. Advisory Committee on Immunization Practices changed the recommendation for routine PCV13 use in immunocompetent adults aged ≥65, including those with certain chronic medical conditions (CMC); PCV13 is now recommended based on shared clinical decision-making. Adults with CMC continue to be at increased risk for pneumococcal disease. We assessed the cost-effectiveness of adding PCV13 to the recommended PPSV23 dose for adults aged ≥19 years with CMC. Methods: We used a probabilistic model following a cohort of 19-year-old U.S. adults. We used Monte Carlo simulation to estimate the impact on program, medical, and non-medical costs (in 2017 U.S. dollars [$] using the societal perspective), and pneumococcal disease burden when administering PCV13 in series with PPSV23. Table 1 shows vaccine effectiveness (VE) assumptions for the base case. We performed one-way sensitivity analyses assuming higher PCV13 VE against serotype 3 disease. Vaccine effectiveness assumptions by age group used for the base case Results: In the base-case scenario, adding a dose of PCV13 upon CMC diagnosis cost $689, 299 per QALY. Results of one-way sensitivity analyses are presented in Table 2. Base case and one-way sensitivity analyses of adding PCV13 at diagnosis of CMC Conclusion: Adding PCV13 in series with PPSV23 for adults 19 years or older with CMC was not cost-saving. Results were sensitive to assumptions on PCV13 VE against serotype 3 disease. Disclosures: All Authors : No reported disclosures