Cost-Effectiveness Assessment of 20-Valent Pneumococcal Conjugate Vaccine (PCV20) Among At-Risk and High-Risk Adults in India
Author(s)
Santosh Taur, MD1, Anu Kristiina Suokas, PhD2, Namrata Kulkarni, MD1, Ahuva Averin, MPP3, Mark Atwood, MS4, Liping Huang, MD, MA, MS5.
1Pfizer Ltd, India, Mumbai, India, 2Avalere Health, Sheffield, United Kingdom, 3Avalere Health, Boston, MA, USA, 4Avalere Health LLC, Boston, MA, USA, 5Director, HEOR, Pfizer, Collegeville, PA, USA.
1Pfizer Ltd, India, Mumbai, India, 2Avalere Health, Sheffield, United Kingdom, 3Avalere Health, Boston, MA, USA, 4Avalere Health LLC, Boston, MA, USA, 5Director, HEOR, Pfizer, Collegeville, PA, USA.
OBJECTIVES: In India, the clinical practice guideline recommends 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPV23) for adults. However, vaccination with PPV23 or PCV13 only is also common clinical practice in private settings. With recent availability of 20-valent PCV (PCV20) in India, we evaluated cost-effectiveness of PCV20 versus PCV13 followed by PPV23 (PCV13◊PPV23) in at-risk/high-risk adults aged ≥50 years(y) from private payer perspective or aged ≥60y from government payer perspective. Additionally, we assessed PCV20 versus PPV23 or PCV13 only from private perspective.
METHODS: A Markov-cohort model was used to project lifetime cases, deaths, and costs associated with invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP) at 5%/year discounting rate for both cost and benefits. Model inputs were based on India-specific published literatures, and cost inputs differed for the analyses from private payer or public payer perspectives. Cost per quality-adjusted life year (QALY) gained was assessed among targeted vaccination populations. Three-time gross domestic product (GDP) per capita of 2024 in India was used as a threshold (₹701,671) for assessing cost effectiveness.
RESULTS: From private payer perspective, PCV20 was estimated to be cost-saving versus PCV13◊PPSV23 (ΔCosts = -₹2,400 million (M); ΔQALYs = 11,385, cost/QALY = dominant) and to be cost effective (CE) versus PPV23 only (ΔCosts = ₹7,783M; ΔQALYs = 40,965, cost/QALY = ₹189,982) or PCV13 only (ΔCosts = ₹7,677M; ΔQALYs = 11,639, cost/QALY = ₹659,591) in at-/high-risk adults ≥50y. From government payer perspective, PCV20 was estimated to be CE versus PCV13◊PPV23 (ΔCosts = ₹10,209M; ΔQALYs = 17,669, cost/QALY = ₹577,810) in at-/high-risk adults ≥60y.
CONCLUSIONS: Compared to PCV13 ◊PPV23, PCV20 in at-/high-risk older adults would be cost-saving and cost-effective from both private and government payer perspectives. Furthermore, from private payer perspective, PCV20 would be cost-effective compared with all other vaccination strategies considered.
METHODS: A Markov-cohort model was used to project lifetime cases, deaths, and costs associated with invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP) at 5%/year discounting rate for both cost and benefits. Model inputs were based on India-specific published literatures, and cost inputs differed for the analyses from private payer or public payer perspectives. Cost per quality-adjusted life year (QALY) gained was assessed among targeted vaccination populations. Three-time gross domestic product (GDP) per capita of 2024 in India was used as a threshold (₹701,671) for assessing cost effectiveness.
RESULTS: From private payer perspective, PCV20 was estimated to be cost-saving versus PCV13◊PPSV23 (ΔCosts = -₹2,400 million (M); ΔQALYs = 11,385, cost/QALY = dominant) and to be cost effective (CE) versus PPV23 only (ΔCosts = ₹7,783M; ΔQALYs = 40,965, cost/QALY = ₹189,982) or PCV13 only (ΔCosts = ₹7,677M; ΔQALYs = 11,639, cost/QALY = ₹659,591) in at-/high-risk adults ≥50y. From government payer perspective, PCV20 was estimated to be CE versus PCV13◊PPV23 (ΔCosts = ₹10,209M; ΔQALYs = 17,669, cost/QALY = ₹577,810) in at-/high-risk adults ≥60y.
CONCLUSIONS: Compared to PCV13 ◊PPV23, PCV20 in at-/high-risk older adults would be cost-saving and cost-effective from both private and government payer perspectives. Furthermore, from private payer perspective, PCV20 would be cost-effective compared with all other vaccination strategies considered.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE228
Topic
Economic Evaluation, Health Policy & Regulatory
Disease
Vaccines