Cost-effectiveness analysis of adult pneumococcal conjugate vaccines for pneumococcal disease in Japan.

IF 5.5 3区医学 Q1 IMMUNOLOGY Expert Review of Vaccines Pub Date : 2024-01-01 Epub Date: 2024-05-09 DOI:10.1080/14760584.2024.2350246

Shigeki Nakamura, Masashi Mikami, Tomoyuki Hayamizu, Naohiro Yonemoto, Camille Moyon, Mark Gouldson, Catriona Crossan, Jeffrey Vietri, Kazumasa Kamei

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Abstract

Background: The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is used in the Japanese National Immunization Program for older adults and adults with increased risk for pneumococcal disease, however, disease incidence and associated burden remain high. We evaluated the cost-effectiveness of pneumococcal conjugate vaccines (PCVs) for adults aged 65 years and high-risk adults aged 60-64 years in Japan.

Research design and methods: Using a Markov model, we evaluated lifetime costs using societal and healthcare payer perspectives and estimated quality-adjusted life-years (QALYs), and number of prevented cases and deaths caused by invasive pneumococcal disease (IPD) and non-IPD. The base case analysis used a societal perspective.

Results: In comparison with PPSV23, the 20-valent PCV (PCV20) prevented 127 IPD cases 10,813 non-IPD cases (inpatients: 2,461, outpatients: 8,352) and 226 deaths, and gained more QALYs (+0.0015 per person) with less cost (-JPY22,513 per person). All sensitivity and scenario analyses including a payer perspective analysis indicated that the incremental cost-effectiveness ratios (ICERs) were below the cost-effectiveness threshold value in Japan (JPY5 million/QALY).

Conclusions: PCV20 is both cost saving and more effective than PPSV23 for adults aged 65 years and high-risk adults aged 60-64 years in Japan.

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日本成人肺炎球菌结合疫苗治疗肺炎球菌疾病的成本效益分析。

背景：在日本国家免疫计划中，23 价肺炎球菌多糖疫苗 (PPSV23) 被用于老年人和肺炎球菌疾病风险较高的成年人，然而，疾病发病率和相关负担仍然很高。我们评估了日本 65 岁成人和 60-64 岁高风险成人接种肺炎球菌结合疫苗 (PCV) 的成本效益：我们使用马尔可夫模型，从社会和医疗支付方的角度评估了终生成本，并估算了质量调整生命年 (QALY)，以及由侵袭性肺炎球菌疾病 (IPD) 和非 IPD 引起的预防病例数和死亡数。基础案例分析采用了社会视角：结果：与 PPSV23 相比，20 价 PCV（PCV20）可预防 127 例 IPD 病例、10,813 例非 IPD 病例（住院病人：2,461 例，门诊病人：8,352 例）和 226 例死亡，并以较低的成本（每人-22,513 日元）获得了更多的 QALY（每人+0.0015）。所有敏感性分析和情景分析（包括支付方视角分析）均表明，增量成本效益比（ICER）低于日本的成本效益阈值（500 万日元/QALY）：结论：对于日本 65 岁的成年人和 60-64 岁的高风险成年人来说，PCV20 比 PPSV23 既节约成本又更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Vaccines 医学-免疫学

CiteScore

9.10

自引率

3.20%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Expert Review of Vaccines (ISSN 1476-0584) provides expert commentary on the development, application, and clinical effectiveness of new vaccines. Coverage includes vaccine technology, vaccine adjuvants, prophylactic vaccines, therapeutic vaccines, AIDS vaccines and vaccines for defence against bioterrorism. All articles are subject to rigorous peer-review. The vaccine field has been transformed by recent technological advances, but there remain many challenges in the delivery of cost-effective, safe vaccines. Expert Review of Vaccines facilitates decision making to drive forward this exciting field.