ECONOMIC IMPACT OF INTRODUCING PCV20 IN COLOMBIAN PEDIATRIC POPULATION: A COST UTILITY ANALYSIS
Author(s)
Maria Carrasquilla-Sotomayor, MD1, Juan C. Alvarado-Gonzalez, MSc2, Fernando E. Salcedo Mejía, BEc, MSc1, Rosmery V. Barroso, Econ2, Nelson José Alvis Zakzuk, MSc3;
1Alzak Foundation, Cartagena, Colombia, 2ALZAK, Cartagena, Colombia, 3University of Sao Paulo, Sao Paulo, Brazil
1Alzak Foundation, Cartagena, Colombia, 2ALZAK, Cartagena, Colombia, 3University of Sao Paulo, Sao Paulo, Brazil
OBJECTIVES: To estimate the Cost-Effectiveness of introducing 20-valent pneumococcal conjugated vaccine (PCV20) in a 2 + 1 dose vaccination schedule in Colombian children < 5 years, compared to PCV13 and PCV15.
METHODS: A decision-tree model was conducted considering two cohort scenarios: a fixed and a dynamic cohort from a societal perspective, including productivity losses. PCV20 was compared to PCV13 and PCV15. Life expectancy was modeled and health outcomes included invasive pneumococcal disease, community-acquired pneumonia, acute otitis media, and death. Incidence and mortality rates were extracted from local evidence, while vaccine prices were derived from PAHO and the national drug-price database. Vaccine efficacy was derived from clinical trials and adjusted with serotype coverage extracted from Colombian authorities. Finally, costs were estimated using national guidelines adjusted with costs from a Colombian HMO. A 5% annual discount rate was applied. Probabilistic sensitivity analyses and cost-effectiveness acceptability curves were used to assess parameter uncertainty.
RESULTS: In the fixed cohort, PCV20 was cost-effective against PCV13 (ICER: USD$2,125 per QALY), and dominant against PCV15; similar results were observed in the dynamic cohort. When the indirect effect of herd protection in adults was included, PCV20 remains dominant over all strategies. PCV20 showed a 65% probability of being the most cost-effective strategy (willingness-to-pay threshold = USD$7,701). Additionally, PCV20 could prevent the greatest number of pneumococcal disease cases and deaths in the fixed cohort, averting up to 1,092 pneumonia cases compared to PCV13 and PCV15, resulting in 5,171 life-years gained.
CONCLUSIONS: PCV20 offers a highly efficient alternative for the prevention of pneumococcal diseases, compared to PCV13 and PCV15, with greater clinical impact in terms of prevented cases and it’s also associated with lower total costs from the societal perspective. This evidence supports the inclusion of PCV20 as a preferred option in national immunization programs.
METHODS: A decision-tree model was conducted considering two cohort scenarios: a fixed and a dynamic cohort from a societal perspective, including productivity losses. PCV20 was compared to PCV13 and PCV15. Life expectancy was modeled and health outcomes included invasive pneumococcal disease, community-acquired pneumonia, acute otitis media, and death. Incidence and mortality rates were extracted from local evidence, while vaccine prices were derived from PAHO and the national drug-price database. Vaccine efficacy was derived from clinical trials and adjusted with serotype coverage extracted from Colombian authorities. Finally, costs were estimated using national guidelines adjusted with costs from a Colombian HMO. A 5% annual discount rate was applied. Probabilistic sensitivity analyses and cost-effectiveness acceptability curves were used to assess parameter uncertainty.
RESULTS: In the fixed cohort, PCV20 was cost-effective against PCV13 (ICER: USD$2,125 per QALY), and dominant against PCV15; similar results were observed in the dynamic cohort. When the indirect effect of herd protection in adults was included, PCV20 remains dominant over all strategies. PCV20 showed a 65% probability of being the most cost-effective strategy (willingness-to-pay threshold = USD$7,701). Additionally, PCV20 could prevent the greatest number of pneumococcal disease cases and deaths in the fixed cohort, averting up to 1,092 pneumonia cases compared to PCV13 and PCV15, resulting in 5,171 life-years gained.
CONCLUSIONS: PCV20 offers a highly efficient alternative for the prevention of pneumococcal diseases, compared to PCV13 and PCV15, with greater clinical impact in terms of prevented cases and it’s also associated with lower total costs from the societal perspective. This evidence supports the inclusion of PCV20 as a preferred option in national immunization programs.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE303
Topic
Economic Evaluation
Disease
SDC: Pediatrics, STA: Vaccines