Cost-Effectiveness of 20-Valent Pneumococcal Conjugate Vaccine (PCV20) Among High-Risk Adults in Taiwan
Author(s)
Ya-Min Yang, MSc, PhD, MD1, Yi-Wei Wang, MS1, Ahuva Averin, MPP2, Anu Kristiina Suokas, PhD3, Mark Atwood, MS4, Mary Cecil, BS2, Liping Huang, MD, MA, MS5.
1Pfizer, Taipei, Taiwan, 2Avalere Health, Boston, MA, USA, 3Avalere Health, Sheffield, United Kingdom, 4Avalere Health LLC, Boston, MA, USA, 5Director, HEOR, Pfizer, Collegeville, PA, USA.
1Pfizer, Taipei, Taiwan, 2Avalere Health, Boston, MA, USA, 3Avalere Health, Sheffield, United Kingdom, 4Avalere Health LLC, Boston, MA, USA, 5Director, HEOR, Pfizer, Collegeville, PA, USA.
OBJECTIVES: The Taiwan Centers for Disease Control (CDC) recommends vaccination with 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPV23; PCV13→PPV23) among adults aged 18-64 with immunocompromising (i.e., high-risk) conditions and all adults aged ≥65 years. We conducted a cost-effectiveness analysis (CEA) of novel 20-valent PCV (PCV20) versus current recommendations of PCV13→PPV23 among adults in Taiwan.
METHODS: A Markov-type cohort model projected lifetime risks and costs of invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP), and the expected impact of vaccination among adults aged 18-64 with high-risk conditions and all adults aged ≥65 years. Outcomes were estimated annually based on published literature and available local data for disease/fatality rates, vaccine effectiveness, vaccine coverage, health state utilities/disutilities, and medical care costs. Cost per quality-adjusted life year (QALY) gained for PCV20 versus PCV13àPPV23 was compared from the healthcare system perspective (3%/year discounting) over a lifetime modeling horizon. Scenario and probabilistic sensitivity analyses (PSA) were performed.
RESULTS: PCV20 was estimated to reduce 29 and 4,655 IPD and NBP cases, respectively, and 160 deaths of the model population. Net costs (vaccination + medical) decreased by NT$ 2.3B and QALYs increased by 944, respectively, making PCV20 the dominant strategy compared to PCV13→PPV23. PCV20 remained cost saving (vs. PCV13→PPV23) among subgroups, and in scenario and sensitivity analyses, including PSA in which 100% of simulations yielded a dominant cost-effectiveness ratio.
CONCLUSIONS: CEA suggests use of PCV20—in lieu of current Taiwan CDC recommendations for pneumococcal vaccination in high-risk adults aged 18-64 years and all adults aged ≥65 years—would be cost saving and represent an efficient use of healthcare resources and would substantially reduce the numbers of cases and deaths due to pneumococcal disease.
METHODS: A Markov-type cohort model projected lifetime risks and costs of invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP), and the expected impact of vaccination among adults aged 18-64 with high-risk conditions and all adults aged ≥65 years. Outcomes were estimated annually based on published literature and available local data for disease/fatality rates, vaccine effectiveness, vaccine coverage, health state utilities/disutilities, and medical care costs. Cost per quality-adjusted life year (QALY) gained for PCV20 versus PCV13àPPV23 was compared from the healthcare system perspective (3%/year discounting) over a lifetime modeling horizon. Scenario and probabilistic sensitivity analyses (PSA) were performed.
RESULTS: PCV20 was estimated to reduce 29 and 4,655 IPD and NBP cases, respectively, and 160 deaths of the model population. Net costs (vaccination + medical) decreased by NT$ 2.3B and QALYs increased by 944, respectively, making PCV20 the dominant strategy compared to PCV13→PPV23. PCV20 remained cost saving (vs. PCV13→PPV23) among subgroups, and in scenario and sensitivity analyses, including PSA in which 100% of simulations yielded a dominant cost-effectiveness ratio.
CONCLUSIONS: CEA suggests use of PCV20—in lieu of current Taiwan CDC recommendations for pneumococcal vaccination in high-risk adults aged 18-64 years and all adults aged ≥65 years—would be cost saving and represent an efficient use of healthcare resources and would substantially reduce the numbers of cases and deaths due to pneumococcal disease.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE232
Topic
Economic Evaluation, Epidemiology & Public Health
Disease
Infectious Disease (non-vaccine), Vaccines