Cost-Effectiveness Analysis of PCV13 Vs PCV10 for the Prevention of Invasive Pneumococcal Disease in the Vietnam Pediatric Population

OBJECTIVES: Both 10- and 13-valent pneumococcal conjugate vaccines (PCV13, PCV10) are available in Vietnam. The objective of the study was to compare clinical and budget impacts of vaccinating children with PCV13 versus PCV10 in Vietnam as well as to assess PCV13 cost-effectiveness from a payer perspective.

METHODS: A decision-analytic Markov model was used to compare PCV13 (3+1) versus PCV10 (3+1) over a 10-year time horizon with 3% discounting rate. Epidemiological, cost, and utility inputs were mostly sourced from published literature relevant to Vietnam. Due to limited serotype coverage data in Vietnam, serotype coverage from Thailand Ministry of Health, a neighboring country with similar PCV situation, was used for the base-case analysis and a historical regional serotype coverage from one city of Vietnam was used for a sensitivity analysis. Direct vaccine effects were estimated from clinical efficacy and effectiveness studies from PCVs. Indirect effect and non-medical costs were not considered, and $48.74 and $42.06 per dose were assumed for PCV13 and PCV10, respectively. Scenario analyses were performed using varying vaccination rates based on the base-case assumptions.

RESULTS:

With 30% vaccination rate in eligible children, compared to PCV10, the base-case results indicated that PCV13 could avert additional 2,292 IPD and 37,663 pneumonia and 18,774 otitis medica (OM) cases and 345 deaths over 10 years, and could save $6.18 million USD. Considering the estimated net costs and quality-adjusted life-years (QALY) saved, the incremental cost effectiveness ratio (ICER) of PCV13 vs. PCV10 was $6,023 per QALY for the base-case analysis, and $12,710/QALY for the sensitivity analysis. The scenario analyses based on vaccination rate indicated the higher the vaccinate rate, the lower the ICER/QALY.

CONCLUSIONS: Based on the willingness to pay threshold according to 3XGDP per capita in Vietnam in 2023 ($12,948), PCV13 is more cost-effective vaccination strategy then PCV10 in Vietnam.