The Strategic Approach

Pneumococcal disease remains a major cause of morbidity and mortality in adults aged 50 years and older or living with chronic comorbidities. While PCV20 and PCV15 have served as the historical standard,the recent FDA approval of Capvaxive™ (PCV21) introduced a more targeted clinical pathway. By evaluating both the clinical and economic implications of Capvaxive adoption, hospitals can provide patients with broader pneumococcal coverage and achieve annual cost savings.

Collaborating with Yankee Alliance, Berkshire Health System conducted a medication evaluation analysis to assess the clinical impact and cost savings of transitioning from the current pneumococcal vaccination strategy with PCV20 to Capvaxive. The hospital focused on quantifying potential cost savings through the GPO contract while reviewing clinical coverage differences, safety and immunogenicity data,and operational considerations for implementation.

The methodology included:

• Conducted a budget impact analysis using historical vaccination volumes

• Compared acquisition costs for PCV20 versus Capvaxive for all wholesaler types including GPO, WAC and 340B

• Reviewed differences in sero type coverage based on clinical data

• Evaluated safety and immunogenicity evidence to support formulary substitution

• Assessed operational considerations, including:

 - Updates to EHR order sets

- Removal ofPCV20 inventory to reduce duplication risk

- Education and training for providers and nursing staff

• Considered CDC/ACIP guideline updates to ensure alignment with recommendations

The Results

Implementation barriers:

• EHR update required to integrate Capvaxive into vaccine order sets

• Provider and nursing staff education needed regarding interchangeability and timing

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P&T considerations:

•  Review of comparative immunogenicity and safety data betweenPCV20 and Capvaxive

•  Alignment with CDC/ACIP recommendations • Cost-benefit analysis

Conclusion

Berkshire Health System, in conjunction with Yankee Alliance, was able to identify $72,000 dollars in pharmacy savings by switching from PCV20 to Capvaxive. The evaluation supported Capvaxive as the preferred option for adult pneumococcal vaccination at Berkshire Health Systems due to expanded clinical protection and substantial financial benefit. While operation adjustments are necessary, the adoption of Capvaxive aligns with the institutions priorities of improving patient outcomes while considering acquisition cost.

To learn more, view success story.

For more information or questions about Yankee Alliance Medication Evaluations, please reach out to Bob Ritchie rritchie@YANKEEALLIANCE.COM.

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