Evidence map›Paper›PMID 37515068›Full record

ArticleVaccines2023

Cost-Effectiveness of Pneumococcal Vaccination in Adults in Italy: Comparing New Alternatives and Exploring the Role of GMT Ratios in Informing Vaccine Effectiveness.

Vincenzo Restivo, Vincenzo Baldo, Laura Sticchi, Francesca Senese, Gian Marco Prandi, Linde Pronk, Kwame Owusu-Edusei, Kelly D Johnson, Tim Ignacio

Open access · goldAbstract read
In one paragraph

Article in Vaccines, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Journal of preventive medicine and hygiene · 2026
    Article
  3. Article
  4. Review
  5. Recommendations on PCV20 vaccine in adults and at-risk populations.European respiratory review : an official journal of the European Respiratory Society · 2025
    Review
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Vincenzo RestivoDepartment of Health Promotion, Mother-Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy.ORCID 0000-0002-5406-884X
Vincenzo BaldoHygiene and Public Health Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy.ORCID 0000-0001-6012-9453
Laura SticchiDepartment of Health Sciences, University of Genoa, 16100 Genoa, Italy.ORCID 0000-0002-7819-7400
Francesca SeneseMarket Access, MSD Italy, 00189 Rome, Italy.
Gian Marco PrandiMedical Affairs, MSD Italy, 00189 Rome, Italy.ORCID 0000-0002-0700-4843
Linde PronkOPEN Health Group, 3068 AV Rotterdam, The Netherlands.
Kwame Owusu-EduseiMerck & Co., Inc., Rahway, NJ 07065, USA.ORCID 0000-0002-4519-2857
Kelly D JohnsonMerck & Co., Inc., Rahway, NJ 07065, USA.ORCID 0000-0002-4275-6135
Tim IgnacioOPEN Health Group, 3068 AV Rotterdam, The Netherlands.
Merck & Co., Inc., Rahway, NJ, USA (United States) · USMSD (Italy) · ITThe Open Group · GBUniversity of Genoa · ITUniversity of Padua · ITUniversity of Palermo · IT

Funding

MSD (Italy) NA
6 · The paper itself

Abstract

In Italy, a sequential pneumococcal vaccination with conjugate vaccine (PCV) and polysaccharide vaccine (PPSV23) is recommended for individuals aged ≥ 65 years and those at risk for pneumococcal disease (PD) aged ≥ 6 years. The aim of this study was to assess the cost-effectiveness of the new vaccines, i.e., approved 15-valent and 20-valent PCVs. A published Markov model was adapted to evaluate the lifetime cost-effectiveness of vaccination with PCV15 + PPSV23 versus PCV13 + PPSV23, PCV20 alone, PCV20 + PPSV23, and No Vaccination. Simulated cohorts representing the Italian population, including individuals aged ≥ 65 years, those at risk aged 50-100 years, and those deemed high risk aged 18-100 years were assessed. Outcomes were accrued in terms of incremental PD cases, costs, quality-adjusted life years, life years, and the cost-utility ratio relative to PCV13 + PPSV23. The conservative base case analysis, including vaccine efficacy based on PCV13 data, showed that sequential vaccination with PCV15 or PCV20 in combination with PPSV23 is preferred over sequential vaccination with PCV13 + PPSV23. Especially in the high-risk group, PCV15 + PPSV23 sequential vaccination was dominant over No Vaccination and resulted in an ICUR of €3605 per QALY gained. Including PCV20 + PPSV23 into the comparison resulted in the domination of the PCV15 + PPSV23 and No Vaccination strategies. Additionally, explorative analysis, including the geometric mean titer (GMT) informed vaccine effectiveness (VE) was performed. In the low-risk and high-risk groups, the results of the GMT scenarios showed PCV15 + PPSV23 to be dominant over the other sequential vaccines. These findings suggest that if real-world studies would confirm a difference in vaccine effectiveness of PCV15 and PCV20 versus PCV13 based on GMT ratios, PCV15 + PPSV23 could prove a highly immunogenic and effective vaccination regime for the Italian adult population.

Indexed as

cost-effectiveness modelsgeometric mean titerItalynon-bacteremic pneumococcal pneumoniapneumococcal diseasesequential vaccination

Identifiers

PMID37515068
PMCPMC10384960
OpenAlexW4384825303

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.