Cost-Effectiveness Analysis of PCV20 3+1 Versus PCV15 2+1 Vaccination of the Pediatric Population in the Netherlands

Speaker(s)

Ta A1, Vinand E1, Peters M2, Cakar E3, Ilic A4, Perdrizet J5
1Cytel, London, London, UK, 2Pfizer, Capelle aan den IJssel, Netherlands, 3Pfizer, Capelle aan den IJssel, Zuid Holland, Netherlands, 4Pfizer, London, UK, 5Global Value and Evidence, Pfizer Canada, Toronto, ON, Canada

Presentation Documents

OBJECTIVES: In 2024, the Netherlands will implement a 15-valent pneumococcal conjugate vaccine (PCV15) in the paediatric national immunization program (NIP) in a 2+1 schedule. A 20-valent PCV (PCV20), approved by the European Medicines Agency in a 3+1 schedule in March 2024, is not yet offered to children in the Netherlands. This study examined the cost-effectiveness of PCV20 3+1 versus PCV15 2+1 in the Dutch paediatric NIP.

METHODS: A Markov model utilizing multiple cohorts with annual cycles over 10 years was adapted to evaluate the impact of PCV20 versus PCV15 from the Dutch societal perspective. Vaccine direct and indirect effects were estimated using 10-valent and 13-valent PCV effectiveness, 7-valent PCV efficacy, and 13-valent PCV impact data. Parameters including epidemiology, cost, and quality of life were informed by Dutch-specific sources. Annual discount rates of 1.5% and 3.0% were applied for benefits and costs, respectively. Outcomes included PD cases, deaths, costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios.

RESULTS: In the base case, PCV20 was estimated to reduce more of the clinical and economic burden of PD than PCV15, yielding total cost savings of €29,365,696 and 33,232 QALYs gained over 10 years, making it the dominant strategy. PCV20 averted 3,444 cases of invasive PD, 15,296 and 12,425 cases of hospitalised and non-hospitalised pneumonia, respectively, 26,492 cases of otitis media, and 1,561 deaths versus PCV15. Despite higher vaccination costs associated with the extra dose versus PCV15, PCV20 was anticipated to yield overall cost savings by reducing direct and indirect medical expenses related to PD. Minimal deviation from the base case was observed in sensitivity and scenario analyses.

CONCLUSIONS: Offering broader serotype coverage, PCV20 3+1 demonstrated dominance versus PCV15 2+1. These findings advocate for the inclusion of PCV20 in the Dutch paediatric NIP.

Code

EE292

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Pediatrics, Vaccines