Evaluating the potential lifetime health and economic impact of PCV21, an adult-specific 21-valent pneumococcal conjugate vaccine, on invasive pneumococcal disease in adults aged ≥45 years in Spain.
Simuzingili Muloongo M, Fernández-Soberón Silvia S, Yi Zinan Z, Cossrow Nicole N et al.
PCV21, a 21-valent pneumococcal conjugate vaccine (PCV), includes eight unique serotypes not covered by other currently licensed pneumococcal vaccines, and accounts for approximately 79% of IPD cases among adults aged ≥65 years in Spain, compared with 65% for PCV20. This study evaluated the potential lifetime health and economic impact of PCV21 compared with PCV20 vaccination on IPD among adults aged ≥45 years in Spain. A published Markov model estimated the lifetime IPD cases, IPD-related deaths, and associated direct medical costs (2024 Euros) for Spanish adults aged 45-64 and ≥ 65 years vaccinated with either PCV21 or PCV20. A sensitivity analysis assessed the effect of varying inputs on the direct costs averted by PCV21 compared with PCV20. For adults aged 45-64 years, PCV21 was projected to prevent 1590 IPD cases and 134 IPD-related deaths, compared with 1412 cases and 114 deaths prevented with PCV20. Compared with PCV20, PCV21 averted 13% more IPD cases and 17% more IPD-related deaths. The greater reduction in IPD burden translated into €7.3 million in direct medical costs saved with PCV21, 10% higher than the €6.6 million saved with PCV20. Among adults aged ≥65 years, PCV21 was projected to prevent 10,262 IPD cases and 2207 IPD-related deaths, compared with 8243 cases and 1772 deaths prevented with PCV20. Compared with PCV20, PCV21 averted 24% more IPD cases and 25% more IPD-related deaths. The corresponding economic impact was also higher with PCV21, with €1301 million in direct medical costs saved compared with €1044 million for PCV20, representing a 25% greater reduction in costs. In both age groups, PCV21 showed greater health and economic impact associated with IPD compared with PCV20, underscoring the potential benefits of incorporating PCV21 into adult pneumococcal vaccination strategies in Spain.