COST‑EFFECTIVENESS OF 20- AND 15‑VALENT PNEUMOCOCCAL CONJUGATE VACCINES FOR CHILDREN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF ECONOMIC EVALUATIONS
Author(s)
Muhammed Rashid, PhD1, Haeseon Lee, MSc, PharmD1, Sajesh Veettil, PhD2, Mark Rozenbaum, MBA, PhD3, Sophie Warren, MSc4, Liping Huang, MPH5, Nathorn Chaiyakunapruk, PharmD, PhD1.
1Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA, 2IMU University, Kuala Lampur, Malaysia, 3Pfizer, Capelle aan den IJssel, Netherlands, 4Pfizer, Cambridge, MA, USA, 5Pfizer, New York City, NY, USA.
1Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA, 2IMU University, Kuala Lampur, Malaysia, 3Pfizer, Capelle aan den IJssel, Netherlands, 4Pfizer, Cambridge, MA, USA, 5Pfizer, New York City, NY, USA.
OBJECTIVES: Several economic evaluations have compared the cost-effectiveness of PCV20 and PCV15 with each other and with existing pneumococcal vaccination strategies in children. However, a quantitative synthesis of these findings is lacking. This study aimed to meta-analyse pooled incremental net benefit (INB) estimates for PCV20 and PCV15 in paediatric populations.
METHODS: PubMed, Embase, Web of Science and EconLit were searched from May 2022 to March 2026. Cost-effectiveness and cost-utility studies comparing PCV20 and/or PCV15 with each other or/and with existing pneumococcal vaccination strategies in children were included. All monetary values were converted to purchasing power parity and standardised to 2025 US dollars. INBs were calculated and pooled using a random-effects meta-analysis, stratified by country income level, perspective, and inclusion of herd effects. Statistical significance was defined as 95% confidence intervals (CIs) excluding zero.
RESULTS: Of 854 records identified, 33 studies met inclusion criteria included (30 from high-income[HICs], 2 upper middle-income[UMICs], 1 low-and middle-income country[LMICs]).In HICs, PCV20 was consistently cost-effective compared with PCV15 and PCV13 over a 10-year time. From the payer perspective, pooled INBs were statistically significant (vs PCV15:112.50[95%CI:90.32-134.68], N=15; vs PCV13: 684[95%CI:582.80-786.15], N=13). Similar results were observed from the societal perspectives. Excluding herd effects and applying a shorter 5-year time horizon reduced the magnitude of benefit; but results remained favourable for PCV20 with consistently positive estimates. PCV15 was not significantly cost-effective compared with PCV13 across analyses.In UMICs (N=2), PCV20 showed favourable but non-significant INBs compared with PCV15 and PCV13. All remaining comparisons (including PPSV23 and LMICs) were based on single studies, most indicating higher-valent PCVs were cost-effective or dominant. Findings from HICs were robust across sensitivity analyses.
CONCLUSIONS: PCV20 demonstrated consistent and statistically significant economic value compared with PCV15 and PCV13 in HICs, with directionally favourable results also observed in UMICs. Results were sensitive to consideration of herd effect and time-horizon.
METHODS: PubMed, Embase, Web of Science and EconLit were searched from May 2022 to March 2026. Cost-effectiveness and cost-utility studies comparing PCV20 and/or PCV15 with each other or/and with existing pneumococcal vaccination strategies in children were included. All monetary values were converted to purchasing power parity and standardised to 2025 US dollars. INBs were calculated and pooled using a random-effects meta-analysis, stratified by country income level, perspective, and inclusion of herd effects. Statistical significance was defined as 95% confidence intervals (CIs) excluding zero.
RESULTS: Of 854 records identified, 33 studies met inclusion criteria included (30 from high-income[HICs], 2 upper middle-income[UMICs], 1 low-and middle-income country[LMICs]).In HICs, PCV20 was consistently cost-effective compared with PCV15 and PCV13 over a 10-year time. From the payer perspective, pooled INBs were statistically significant (vs PCV15:112.50[95%CI:90.32-134.68], N=15; vs PCV13: 684[95%CI:582.80-786.15], N=13). Similar results were observed from the societal perspectives. Excluding herd effects and applying a shorter 5-year time horizon reduced the magnitude of benefit; but results remained favourable for PCV20 with consistently positive estimates. PCV15 was not significantly cost-effective compared with PCV13 across analyses.In UMICs (N=2), PCV20 showed favourable but non-significant INBs compared with PCV15 and PCV13. All remaining comparisons (including PPSV23 and LMICs) were based on single studies, most indicating higher-valent PCVs were cost-effective or dominant. Findings from HICs were robust across sensitivity analyses.
CONCLUSIONS: PCV20 demonstrated consistent and statistically significant economic value compared with PCV15 and PCV13 in HICs, with directionally favourable results also observed in UMICs. Results were sensitive to consideration of herd effect and time-horizon.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE73
Topic
Economic Evaluation
Disease
STA: Vaccines