CLINICAL AND ECONOMIC VALUE OF 20-VALENT PNEUMOCOCCAL CONJUGATE VACCINE VERSUS 14-VALENT PNEUMOCOCCAL CONJUGATE VACCINE IN PEDIATRIC POPULATIONS: A MULTI-COUNTRY COST-EFFECTIVENESS ANALYSIS
Author(s)
Liping Huang, MD, MA, MS1, Maria Gabriela Abalos, MD2, Dimitra Anglou, MS3, Irini Zografaki, MD4.
1Director, HEOR, Pfizer, Collegeville, PA, USA, 2Pfizer, Buenos Aires, Argentina, 3Pfizer Inc, London, United Kingdom, 4Pfizer, Athens, Greece.
1Director, HEOR, Pfizer, Collegeville, PA, USA, 2Pfizer, Buenos Aires, Argentina, 3Pfizer Inc, London, United Kingdom, 4Pfizer, Athens, Greece.
OBJECTIVES: Twenty-valent pneumococcal conjugate vaccine (PCV20) offers broader serotype coverage than lower-valency alternatives, with potential for greater reductions in invasive pneumococcal disease (IPD), pneumonia, and otitis media. BioE-PCV14, a lower-cost, WHO-Prequalified vaccine, is an emerging procurement option in LMICs. This analysis evaluated the cost-effectiveness of PCV20 versus BioE-PCV14 in pediatric populations across multiple countries and to assess whether PCV20’s broader serotype coverage justifies its higher cost versus BioE-PCV14.
METHODS: A Markov decision-tree model evaluated cost-effectiveness of PCV20 versus BioE-PCV14 in pediatric cohorts over 10 years. Health states included IPD, and non-invasive PD (hospitalized and non-hospitalized pneumonia, OM), and disease-related death. Vaccine effectiveness varied by dosing schedule (2+1, 3+1, 3+0) and age group; indirect effects followed PCV13 real-impact data; waning was stable for 5 years then declined 10% annually. Analyses covered 2 Upper-Middle ICs (Mexico, Turkey) and 2 LMICs (India, Vietnam) from both public and private payer perspectives and was based on country-specific epidemiological inputs and medical costs. PCV20 was priced at $20/dose; BioE-PCV14 at $7/dose or $10.30-$13/dose (Turkey). WTP thresholds were 1× GDP/capita (Turkey, India, Mexico) and 3× GDP/capita (Vietnam).
RESULTS: Overall, PCV20 averted more cases and deaths than BioE-PCV14 in all scenarios. In Mexico (public payer), PCV20 (2+1) prevented ~2,600 IPD cases, ~487,000 non-invasive cases, and ~3,300 deaths, saving $336M (ICER: −$8,755/QALY). In Turkey (public payer), ICERs ranged $190-$2,263/QALY, well below the threshold, with 5,600-1,900 IPD cases and 3,600-7,200 deaths averted. In India (private payer, PCV20 3+1), PCV20 was near cost-saving versus PCV14(3+0) (ICER: $8/QALY) and highly cost-effective versus PCV14(3+1) (ICER: $1,433/QALY). In Vietnam, public-payer ICERs were $384-$629/QALY and private-payer ICERs $4,448-$5,352/QALY, both below threshold.
CONCLUSIONS: PCV20 was cost-effective or cost-saving versus BioE-PCV14 across all four countries from both private and public payer perspectives. Its broader serotype coverage drives greater reductions in pneumococcal disease burden and mortality, supporting its value in LMICs.
METHODS: A Markov decision-tree model evaluated cost-effectiveness of PCV20 versus BioE-PCV14 in pediatric cohorts over 10 years. Health states included IPD, and non-invasive PD (hospitalized and non-hospitalized pneumonia, OM), and disease-related death. Vaccine effectiveness varied by dosing schedule (2+1, 3+1, 3+0) and age group; indirect effects followed PCV13 real-impact data; waning was stable for 5 years then declined 10% annually. Analyses covered 2 Upper-Middle ICs (Mexico, Turkey) and 2 LMICs (India, Vietnam) from both public and private payer perspectives and was based on country-specific epidemiological inputs and medical costs. PCV20 was priced at $20/dose; BioE-PCV14 at $7/dose or $10.30-$13/dose (Turkey). WTP thresholds were 1× GDP/capita (Turkey, India, Mexico) and 3× GDP/capita (Vietnam).
RESULTS: Overall, PCV20 averted more cases and deaths than BioE-PCV14 in all scenarios. In Mexico (public payer), PCV20 (2+1) prevented ~2,600 IPD cases, ~487,000 non-invasive cases, and ~3,300 deaths, saving $336M (ICER: −$8,755/QALY). In Turkey (public payer), ICERs ranged $190-$2,263/QALY, well below the threshold, with 5,600-1,900 IPD cases and 3,600-7,200 deaths averted. In India (private payer, PCV20 3+1), PCV20 was near cost-saving versus PCV14(3+0) (ICER: $8/QALY) and highly cost-effective versus PCV14(3+1) (ICER: $1,433/QALY). In Vietnam, public-payer ICERs were $384-$629/QALY and private-payer ICERs $4,448-$5,352/QALY, both below threshold.
CONCLUSIONS: PCV20 was cost-effective or cost-saving versus BioE-PCV14 across all four countries from both private and public payer perspectives. Its broader serotype coverage drives greater reductions in pneumococcal disease burden and mortality, supporting its value in LMICs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE141
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Pediatrics, Vaccines