1884. Cost-Effectiveness of Alternative Strategies for Use of 13-Valent Pneumococcal Conjugate Vaccine (PCV13) in Canadian Adults
Session: Poster Abstract Session: Vaccines: PCV
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • Canada adult PCV13 cost_effectiveness ID week 2015 final.pdf (1.1 MB)
  • Background: The National Advisory Committee on Immunization (NACI) recommends broad use of PCV13 in infants, the 23-valent pneumococcal polysaccharide vaccine (PPV23) in adults ≥65 years, and both vaccines sequentially for adults with immunocompromising conditions.  In light of recent PCV13 efficacy results from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA), and new sero-epidemiology data on pneumonia caused by PCV13 serotypes in Canadian adults, we examined the economic implications of funding an expanded PCV13 immunization program. 

    Methods: A microsimulation model depicting expected lifetime risks, consequences, and costs of invasive pneumococcal disease (IPD) and all-cause pneumonia (ACP) in Canadian adults was developed. PPV23 effectiveness was based on published literature; PCV13 effectiveness was based on data from CAPiTA.  Rates of ACP in different age groups were estimated from the Canadian Institute of Health Information hospital Discharge Abstract Database (CIHI DAD). The proportion of ACP caused by PCV13 serotypes was estimated from the Serious Outcomes Surveillance (SOS) Network using serotype-specific urinary antigen detection assay. Herd effects were included in the model based on previous observations with PCV7 in Canada. Outcomes and costs were evaluated for three alternative populations: (1) immunocompromised persons 18-99 at model entry (n=1.4M); (2) immunocompromised persons 18-64 and all persons ≥65 at model entry (n=6.2M); and (3) immunocompromised and high-risk persons 18-64 and all persons ≥65 at model entry (n=13.8M).  Vaccination strategy compared use of PPV23 alone “current strategy” with use of PCV13 followed by PPV23 “proposed strategy”.

    Results: Implementing an expanded program with PCV13 followed by PPV23 (in lieu of PPV23 alone) would be cost saving for populations 1 & 2 and highly cost-effective for population 3 (Table).

    Table. Cost-effectiveness of proposed strategies for expanded use of PCV13

    Table 3

    Conclusion: Implementing the proposed vaccine program with PCV13 followed by PPV23 in Canadian adults would be cost-saving or a highly cost-effective use of scarce healthcare resources.

    Derek Weycker, Ph.D.1, Mark Atwood, MS1, Reiko Sato, PhD2, Linda Beausoleil, BA3, Craig Laferriere, PhD4 and Shelly a. Mcneil, MD, FRCPC, FIDSA5, (1)Policy Analysis Inc. (PAI), Brookline, MA, (2)Pfizer Inc., Collegeville, PA, (3)Access, Pfizer Canada Inc., Kirkland, QC, Canada, (4)Medical Affairs, Pfizer Canada Inc., Kirkland, QC, Canada, (5)Canadian Center for Vaccinology, IWK Health Center and Capital Health, Dalhousie University, Halifax, NS, Canada

    Disclosures:

    D. Weycker, Pfizer Inc.: Research Contractor , Research support

    M. Atwood, Pfizer Inc.: Consultant , Consulting fee

    R. Sato, Pfizer Inc.: Employee and Shareholder , Salary

    L. Beausoleil, Pfizer Canada Inc: Employee , Salary

    C. Laferriere, Pfizer Canada: Employee and Shareholder , Salary

    S. A. Mcneil, Pfizer Canada Inc.: Grant Investigator and Scientific Advisor , Grant recipient

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