ABSTRACT

Background: The objective of this study was to conduct a cost-effectiveness analysis of PCV13 vs. PPV23 and no vaccination and PPV23 vs. no vaccination in adults aged ≥ 60 years with underlying medical conditions which put them at an elevated risk of pneumococcal disease in a Japanese healthcare setting.

Research design and methods: A natural history model was developed with a life-long time horizon and 1-year cycle length, with microsimulation as a modeling technique. The expected costs from a public payer’s and societal perspective, quality-adjusted life-years (QALYs), and prevented cases and deaths caused by IPD (invasive pneumococcal disease) and NBP (non-bacteremic pneumococcal pneumonia) were estimated.

Results: In the base-case scenario, the cost per QALY gained from a public payer’s perspective for PCV13 vs, PPV23 and no vaccination were 500,255JPY and 1,139,438JPY, respectively, The cost per QALY gained for PPV23 vs no vaccination was 1,687,057JPY. Over the life-long time horizon for 1 million patients, when compared to PPV23, PCV13 resulted in 65 fewer IPD cases, 2,894 fewer NBP cases, and 384 fewer deaths caused by pneumococcal disease.

Conclusions: In adults aged 60 years and over with underlying medical conditions, PCV13 was shown to be a more cost-effective alternative to PPV23.

摘要

背景：本研究的目的是对年龄 ≥ 60 岁的成年人进行 PCV13 与 PPV23 和未接种疫苗以及 PPV23 与未接种疫苗的成本效益分析，这些潜在疾病使他们患肺炎球菌疾病的风险增加。日本的医疗保健环境。

研究设计和方法：以微观模拟作为建模技术，开发了一个具有终身时间范围和 1 年周期长度的自然历史模型。估计了从公共支付者和社会角度、质量调整生命年 (QALYs) 以及由 IPD（侵袭性肺炎球菌病）和 NBP（非菌性肺炎球菌性肺炎）引起的预防病例和死亡的预期成本。

结果：在基本情况下，从公共支付者的角度来看，PCV13 与 PPV23 和未接种疫苗的每 QALY 成本分别为 500,255 日元和 1,139,438 日元，PPV23 与未接种疫苗的每 QALY 成本分别为 1,687,057 日元。在 100 万患者的终生时间范围内，与 PPV23 相比，PCV13 导致 IPD 病例减少 65 例，NBP 病例减少 2,894 例，肺炎球菌疾病导致的死亡人数减少 384 例。

结论：在 60 岁及以上患有基础疾病的成年人中，PCV13 被证明是 PPV23 更具成本效益的替代品。