Streptococcus pneumoniae infection cost-effectiveness of therapy
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Streptococcus pneumoniae infection Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rebecca Cohen
Overview
PCV13 and PPSV23 are the two vaccines used today as preventative measures to target and prevent nonbacterial and bacterial pneumococcal pneumonia. These drugs interact and target the disease differently and thus the cost-effectiveness of routine vaccination at certain ages, for individuals at different risk levels, and in different sequences must be examined. A number of studies have been conducted to research how these vaccines affect patient health while considering their cost in order to compute the price per quality adjusted life year (QALY). Both PCV13 and PPSV23 were found to be cost-effective vaccines to protect against pneumococcal disease.
Cost effectiveness of therapy
Following its FDA approval in late 2011 and successful clinical trials [1][2], PCV13 became the recommended treatment regimen for bacterial penumococcus. PCV13 protects against 13 serotypes of pneumococcal disease reducing the number of cases of bacterial pneumococcus as well as associated medical treatment costs [3] and deaths. PCV13 was found to be effective in preventing vaccine-type pneumococcal disease and vaccine-type nonbacterial, bacterial, and pneumococcal pneumonia, though it was not an effective vaccine for preventing any cause community-acquired pneumonia [1]. Due to its direct and indirect effects, PCV13 is a cost-effective vaccine for pneumococcal disease [4][3][5] and could potentially be a cost-effective candidate for a national immunization program [6]. Studies have found that routine PCV13 vaccination costs between $18500-$28900 per QALY [7][2][8][9]. A vaccination regimen of PCV13 supplemented by the addition of PPSV23 at age 65 increases the cost per QALY to the range of $23400-$30400, though this still falls within the threshold of cost-effective preventative treatment options [8][7] . PCV13 is an especially cost-effective candidate for bacterial pneumococcus prevention when compared to no vaccination in regions where the additional serotypes targeted by PCV13 are prevalent [10].
The other vaccine recommended by the CDC for prevention of pneumococcus is the pneumococcal polysaccharide vaccine, PPSV23. Because it targets even more serotypes than PCV13, PPSV23 is more effective at preventing bacterial pneumococcus. Thus, herd immunity may increase even more with mass vaccination with PPSV23 compared to PCV13 simply because of the inclusion of additional serotypes [5]. However, PPSV23 has no clear effect on nonbacterial pneumococcus, which is a more common form of pneumococcal disease. For this reason, it is a slightly less cost-effective candidate for mass vaccination, with $34600 per QALY for PPSV23 compared to $28900 per QALY for PCV13 [2][5]. At this QALY level, however, PPSV23 is still considered to be a cost-effective vaccination option for prevention of pneumococcal disease.
PCV13 and PPSV23 are both thought to be cost-effective pneumococcal vaccines, though they both protect against pneumococcal disease differently.
References
- ↑ 1.0 1.1 Bonten MJ, Huijts SM, Bolkenbaas M, Webber C, Patterson S, Gault S; et al. (2015). "Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults". N Engl J Med. 372 (12): 1114–25. doi:10.1056/NEJMoa1408544. PMID 25785969.
- ↑ 2.0 2.1 2.2 Smith KJ, Wateska AR, Nowalk MP, Raymund M, Nuorti JP, Zimmerman RK (2012). "Cost-effectiveness of adult vaccination strategies using pneumococcal conjugate vaccine compared with pneumococcal polysaccharide vaccine". JAMA. 307 (8): 804–12. doi:10.1001/jama.2012.169. PMC 3924773. PMID 22357831.
- ↑ 3.0 3.1 Klok RM, Lindkvist RM, Ekelund M, Farkouh RA, Strutton DR (2013). "Cost-effectiveness of a 10- versus 13-valent pneumococcal conjugate vaccine in Denmark and Sweden". Clin Ther. 35 (2): 119–34. doi:10.1016/j.clinthera.2012.12.006. PMID 23312274.
- ↑ Ayieko P, Griffiths UK, Ndiritu M, Moisi J, Mugoya IK, Kamau T; et al. (2013). "Assessment of health benefits and cost-effectiveness of 10-valent and 13-valent pneumococcal conjugate vaccination in Kenyan children". PLoS One. 8 (6): e67324. doi:10.1371/journal.pone.0067324. PMC 3691111. PMID 23826268.
- ↑ 5.0 5.1 5.2 Smith KJ, Wateska AR, Nowalk MP, Raymund M, Lee BY, Zimmerman RK (2013). "Modeling of cost effectiveness of pneumococcal conjugate vaccination strategies in U.S. older adults". Am J Prev Med. 44 (4): 373–81. doi:10.1016/j.amepre.2012.11.035. PMC 3601581. PMID 23498103.
- ↑ Strutton DR, Farkouh RA, Earnshaw SR, Hwang S, Theidel U, Kontodimas S; et al. (2012). "Cost-effectiveness of 13-valent pneumococcal conjugate vaccine: Germany, Greece, and The Netherlands". J Infect. 64 (1): 54–67. doi:10.1016/j.jinf.2011.10.015. PMID 22085813.
- ↑ 7.0 7.1 Chen J, O'Brien MA, Yang HK, Grabenstein JD, Dasbach EJ (2014). "Cost-effectiveness of pneumococcal vaccines for adults in the United States". Adv Ther. 31 (4): 392–409. doi:10.1007/s12325-014-0115-y. PMC 4003344. PMID 24718851.
- ↑ 8.0 8.1 Boccalini S, Bechini A, Levi M, Tiscione E, Gasparini R, Bonanni P (2013). "Cost-effectiveness of new adult pneumococcal vaccination strategies in Italy". Hum Vaccin Immunother. 9 (3): 699–706. PMC 3891731. PMID 23295824.
- ↑ Nuorti JP, Whitney CG, Centers for Disease Control and Prevention (CDC) (2010). "Prevention of pneumococcal disease among infants and children - use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine - recommendations of the Advisory Committee on Immunization Practices (ACIP)". MMWR Recomm Rep. 59 (RR-11): 1–18. PMID 21150868.
- ↑ Urueña A, Pippo T, Betelu MS, Virgilio F, Giglio N, Gentile A; et al. (2011). "Cost-effectiveness analysis of the 10- and 13-valent pneumococcal conjugate vaccines in Argentina". Vaccine. 29 (31): 4963–72. doi:10.1016/j.vaccine.2011.04.111. PMID 21621575.