Public Health and Economic Impact of 13-Valent Pneumococcal Conjugate Vaccine (Pcv13) in Public and Private System Versus Ppsv23 and No Vaccination in Older Adults

Abstract

Pneumococcal disease is a public health concern worldwide. This study evaluates the public health and economic impact of 13-valent pneumococcal conjugate vaccine (PCV13) vaccination in Brazilian adults aged ≥50 years. A cohort model with a Markov-type process depicting expected risk, consequences and costs of pneumococcal disease was developed. PCV13 effectiveness was based on data from CAPiTA; the 23-valent polysaccharide vaccine (PPSV23) effectiveness was based on published literature. Pneumococcal disease rates were based on data from DATASUS. Outcomes, direct and indirect costs (in BRL) were evaluated from a Brazilian public (n= 20,228,045) and private (n=11,396,682) payer perspective over a 5 year time horizon. From a public payer perspective, vaccination with PCV13 versus PPSV23 avoided 676,031 PD cases, 853 deaths with BRL 2,32 million cost saving. An expected 696.970 PD cases and 29.644 deaths would be avoided for PCV13 versus no vaccine 2,16 million cost savings. From a private payer perspective, vaccination with PCV13 versus PPSV23 avoided 410,302 PD cases and 1,074 deaths with a 1.27million cost-savings. An expected 420,159 PD cases and 18,482 deaths would be avoided for PCV13 versus no vaccine with a 1.69 million cost-savings. PCV13 prevents more pneumococcal disease cases and deaths than PPSV23 or no vaccine and is expected to save economic resources (direct and indirect) from a private perspective, and cost-effective from a public perspective.