BACKGROUND: The UK introduced the infant 7-valent pneumococcal conjugate vaccine (PCV7) in 2006 and replaced it with the 13-valent (PCV13) in 2010. A decision-analytic model was developed to estimate the historical clinical and economic impact of UK PCV national programs between 2006 and 2018 under a 2+1 schedule.
METHODS: Historical incidence of invasive pneumococcal disease (IPD), outpatient pneumonia, and otitis media (OM) were obtained from epidemiologic databases supplemented with published and unpublished data. Event costs were from National Health Service Reference Costs 2015-2016, vaccine costs from the British National Formulary, and utility weights from published sources. Two scenarios were considered: (1) the observed historical incidence from 2006-2018 in the setting of PCV use; and (2) a hypothetical scenario in which we estimated the number of disease cases assuming no PCV use. Averted cases, deaths, incremental costs, and quality-adjusted life years (QALYs) were obtained by subtracting the vaccine scenario totals from the no-vaccine scenario totals.
RESULTS: Together PCV7 and PCV13 programs were estimated to have saved 79,712 lives and averted 50,993 IPD cases, 530,271 inpatient pneumonia episodes, and 921,133 OM episodes in the UK from 2006-2018 (Figure 1). This reduction in disease cases produced total cost savings of £681,763,795 and 79,027 QALYs gained over the period. Vaccination costs were more than offset by the direct medical cost savings from fewer cases of IPD, inpatient pneumonia, and OM.
CONCLUSIONS: Infant PCV programs in the UK have provided significant health benefits and resulted in a substantial cost-savings under a 2+1 schedule at list price. These findings highlight the importance of protecting the population under a 2+1 infant PCV schedule to provide sustained reductions in pneumococcal disease and as demonstrated in this analysis, continued return-on-investment
