Estimating the Cost-Effectiveness of Switching to Higher-Valency Pediatric Pneumococcal Conjugate Vaccines in the United Kingdom

Abstract

Currently, the 13-valent pneumococcal conjugate vaccine (PCV13) is administered under a 1+1 (1 primary dose) pediatric schedule in the United Kingdom (UK). Higher-valency PCVs, 15-valent PCV (PCV15), or 20-valent PCV (PCV20) might be considered to expand serotype coverage. We evaluated the cost-effectiveness of PCV20 or PCV15 using either a 2+1 (2 primary doses) or 1+1 schedule for pediatric immunization in the UK. Using a dynamic transmission model, we simulated future disease incidence and costs under PCV13 1+1, PCV20 2+1, PCV20 1+1, PCV15 2+1, and PCV15 1+1 schedules from the UK National Health Service perspective. We prospectively estimated disease cases, direct costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio. Scenario analyses were performed to estimate the impact of model assumptions and parameter uncertainty. Over a five-year period, PCV20 2+1 averted the most disease cases and gained the most additional QALYs. PCV20 2+1 and 1+1 were dominant (cost-saving and more QALYs gained) compared with PCV15 (2+1 or 1+1) and PCV13 1+1. PCV20 2+1 was cost-effective (GBP 8110/QALY) compared with PCV20 1+1. PCV20 was found cost-saving compared with PCV13 1+1, and PCV20 2+1 was cost-effective compared with PCV20 1+1. Policymakers should consider the reduction in disease cases with PCV20, which may offset vaccination costs.

Cost-effectiveness of PCV20 to Prevent Pneumococcal Disease in the Pediatric Population: A German Societal Perspective Analysis

“…In Canada [ 58 ] and Greece [ 59 ], PCV20 was estimated to be cost-saving compared with PCV15 in a 2+1 schedule. In the United Kingdom, PCV20 2+1 was estimated to be cost-saving compared to PCV13 1+1 and cost-effective compared with PCV20 1+1 [ 60 ]. Moreover, a public health impact analysis in the Netherlands estimated that PCV20 could avert 45,127 pneumococcal cases compared to PCV10 over 5 years [ 61 ].…”

Serotype distribution and antimicrobial resistance of pediatric Streptococcus pneumoniae isolated from inpatients and outpatients at Beijing Children's Hospital

“…After further evaluation of its safety, immunogenicity, and effectiveness in pediatric populations, in April 2023, PCV20 received its first pediatric approval, in the USA [27] . The United Kingdom and Canada also estimated that the cost-Effectiveness of PCV20 would be greater than that of PCV13 [ 28 , 29 ]. PCV13 was approved in China in November 2016 and was available in the country in May 2017.…”