A budget impact analysis of 15- or 20- valent pneumococcal conjugate vaccine use in all US adults aged 50–64 years old compared to those with high-risk conditions from US payer perspective

Abstract

Abstract Background In 2023, the US CDC recommended 20-valent pneumococcal conjugate vaccine (PCV20) or 15-valent pneumococcal conjugate vaccine (PCV15) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all adults aged 65-years and older and those aged 19–64 years old with chronic conditions. However, there is substantial pneumococcal disease burden in healthy adults aged 50–64 years, particularly in Black adults, who are likely to benefit from vaccination. This study assesses the financial impact of introducing routine PCV15 or PCV20 in US adults aged 50–64 years. Objective To evaluate the budget impact of introducing PCV20 or PCV15/PPSV23 use in adults aged 50–64 years old compared to vaccinating only those with high-risk conditions for pneumococcal disease. Methods A budget impact model was developed over a 3-year time horizon to compare PCV20 versus PCV15/PPSV23 from the US payer perspective. Outcomes and costs of pneumococcal disease among US adults aged 50–64 years and those with underlying conditions were projected using a Markov decision model. Results Incorporating either PCV20 or PCV15/PPSV23 vaccines in routine vaccination programs for adults aged 50–64 years compared to vaccinating only adults with chronic conditions had an incremental budget impact of $6.5 and $9 billion, respectively, over three years. Budgetary impact was sensitive to number of vaccine doses, cost of vaccine per dose, vaccine coverage proportion and pneumococcal treatment cost across the overall population and sub-groups. Routine vaccination of 50-64-year-old age group was more economically favorable in Black adults sub-group analyses.

Keywords

• Pneumococcal
• Budget impact analyses
• Vaccine
• US
• Adults