Review Demonstrates Impaired Quality of Life in Children With Pneumococcal Disease Despite Variations in Study Methodologies

A literature review of cost-utility analyses (CUAs) of pediatric pneumococcal vaccines and the incidence of pneumococcal disease in pediatric patients found impaired quality of life (QoL) in those impacted by the disease, though the study investigators indicated considerable variability in utility estimates across studies. These variations highlight the challenges present in estimating utilities for acute diseases in pediatric patients, according to insights from the trial published in PharmacoEconomics.¹

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Pneumococcal disease has remained a global health threat, with disproportionate impacts on older adults and children. All children are susceptible to the disease, but those with chronic illnesses or weakened immune systems are at heightened risk. Receiving a pneumococcal vaccine can provide strong protection against severe disease and is recommended for the most at-risk groups, including young children. Many countries across the world now recommend pneumococcal vaccination for this population group, and declines in the proportion of serious complications due to pneumococcal disease in children have been reported by prior authors.^2,3

However, there is a lack of reporting on economic value gained from the widespread implementation of pneumococcal vaccination. This is critical to determine, given the role economic value plays when deciding whether to adopt a new vaccine into national immunization programs. CUAs are often used to conduct economic evaluations of pneumococcal vaccines, but existing CUAs utilize a wide range of values that are often sourced from previous CUAs, without clear rationale for the selection of those values.¹

To better align with utility estimates recommended by major health technology bodies, the study authors sought to conduct a literature review summarizing health utility values and scores used in published CUAs of pneumococcal vaccines. Most importantly, the investigators also aimed to provide an update to previous reviews of the health utilities of pneumococcal disease in children. Overall, they aimed to provide a detailed understanding of the QoL burden associated with pneumococcal disease, which can aid in developing future economic evaluations of disease interventions in children.¹

According to their analysis—which was consistent with the findings of previous reviews—there was a wide range of utility estimates for most disease states in pneumococcal disease. Furthermore, despite published CUAs in North America and Europe applying a wide range of utility inputs, most studies included in the review referred to a single CUA conducted in the United Kingdom. CUAs frequently applied the same utility estimate to a different pneumococcal disease state without considering the variable symptoms and disease courses of the conditions.¹

“The substantial variations in methodologies and utility estimates in the existing literature underscore the inherent challenges in estimating utilities for acute diseases in children, which may explain the general lack of recent high-quality utility studies in pneumococcal disease,” the investigators noted in their discussion.¹

Despite these observations, the current review elucidates the health utilities of children with pneumococcal disease. Utility estimates from original CUA studies sourced during the analysis demonstrated considerable variability, with ranges of −0.330 to 0.6882 for meningitis, −0.331 to 0.93 for nonmeningitis invasive pneumococcal disease, −0.054 to 0.71 for inpatient pneumonia, and 0.412 to 0.82 for outpatient pneumonia, the investigators found. They noted that the previously discussed variability in methods substantially impacted these values.¹

“Utility studies for pneumococcal disease and [postmeningitis sequelae] based on contemporary data and methods adapted for acute diseases in children are needed,” the study authors concluded. “Given the significance of health utilities in the economic values of new pneumococcal vaccines, utility values should be carefully selected in CUAs, and alternative values and assumptions should be evaluated in sensitivity analyses.”¹

REFERENCES

1. Huang M, Zie J, Romdhani H, et al. Global assessment of health utilities associated with pneumococcal disease in children—targeted literature reviews. PharmacoEconomics. 2025. Published online. Accessed June 17, 2025. doi:10.1007/s40273-025-01504-0

2. Halpern L. Declines in pediatric pneumococcal complicated pneumonia evident following introduction of higher valent vaccines. Pharmacy Times. Published May 20, 2025. Accessed June 17, 2025. https://www.pharmacytimes.com/view/declines-in-pediatric-pneumococcal-complicated-pneumonia-evident-following-introduction-of-higher-valent-vaccines

3. Gerlach A. Global review finds gaps in pneumococcal vaccine policies for high-risk children. Pharmacy Times. Published May 10, 2025. Accessed June 17, 2025. https://www.pharmacytimes.com/view/global-review-finds-gaps-in-pneumococcal-vaccine-policies-for-high-risk-children