INTRODUCING IN THE NATIONAL IMMUNIZATION PROGRAM THE 20-VALENT PNEUMOCOCCAL VACCINE IN OLDER ADULTS IN ECUADOR: A COST-UTILITY ANALYSIS
Author(s)
Andreina Jose Alamo, BSc1, Jair A. Arciniegas, MSc2, RICARDO YAJAMIN, MSc3, Jorge LaRotta, MD4, Juan Manuel Reyes, MSc5.
1PFIZER COLOMBIA, Bogota, Colombia, 2Value & Evidence Coordinator, Pfizer SAS, Bogotá, Colombia, 3Value Health Economics Group - HEOR & HTA Consulting, QUITO, Ecuador, 4Pfizer, Bogotá, Colombia, 5Pfizer SAS, Bogotá, Colombia.
1PFIZER COLOMBIA, Bogota, Colombia, 2Value & Evidence Coordinator, Pfizer SAS, Bogotá, Colombia, 3Value Health Economics Group - HEOR & HTA Consulting, QUITO, Ecuador, 4Pfizer, Bogotá, Colombia, 5Pfizer SAS, Bogotá, Colombia.
OBJECTIVES: To evaluate the cost-utility of the potential inclusion of PCV20 in Ecuadorian older-adult population for pneumococcal disease prevention.
METHODS: A decision-tree model that simulated healthy adults aged 65 years or older receiving PCV20 or PCV13 plus 2 doses of PPSV23 compared to no vaccination (NV) was used. The selected technologies are the only options at the PAHO revolving fund and align with local adult pneumococcal prevention guidelines. Model branches depict potential outcomes within a 10-year time horizon, such as staying disease-free, contracting community-acquired pneumonia (CAP), developing IPD, or death. Branch progression was determined by parameters obtained from scientific-literature and national epidemiological databases. Quality-adjusted life years (QALY) were calculated, and only direct medical costs were included, using a 5% discount rate. Costs were sourced from local databases/regulations and were reported in 2026 USD. Sensitivity analyses were conducted.
RESULTS: Under a 40% uptake a total of 639,844 adults were included. Compared to NV it led to avert 20 IPD cases, 5,293 CAP cases and 643 deaths, while PCV13+(2*PPSV23) averted 18 IPD cases, 4,380 CAP cases and 533 deaths compared to NV. The estimated medical cost under the NV scenario was approximately 9.2 million, while with PCV20 it was 7.1 million and with PCV13+(2*PPSV23) it was 7.4 million. Vaccination cost differs substantially, with PCV20 it was 13.4 million and with PCV13+(2*PPSV23) 23.8 million. The incremental cost-effectiveness ratio (ICER) of PCV20 vs. NV was 775 USD per QALY, and the ICER of PCV13+(2*PPSV23) vs. NV was 1,824 USD per QALY, figures below the one-GDP-per-capita WTP threshold (6,939 USD).
CONCLUSIONS: PCV20 represented the most efficient strategy, representing a lesser cost per QALY. PCV20 could substantially mitigate the health-economic burden of pneumococcal diseases, being a cost-effective strategy compared to NV and providing a lower ICER than the PCV13+(2*PPSV23) scheme in adults aged ≥65 years from the healthcare system perspective.
METHODS: A decision-tree model that simulated healthy adults aged 65 years or older receiving PCV20 or PCV13 plus 2 doses of PPSV23 compared to no vaccination (NV) was used. The selected technologies are the only options at the PAHO revolving fund and align with local adult pneumococcal prevention guidelines. Model branches depict potential outcomes within a 10-year time horizon, such as staying disease-free, contracting community-acquired pneumonia (CAP), developing IPD, or death. Branch progression was determined by parameters obtained from scientific-literature and national epidemiological databases. Quality-adjusted life years (QALY) were calculated, and only direct medical costs were included, using a 5% discount rate. Costs were sourced from local databases/regulations and were reported in 2026 USD. Sensitivity analyses were conducted.
RESULTS: Under a 40% uptake a total of 639,844 adults were included. Compared to NV it led to avert 20 IPD cases, 5,293 CAP cases and 643 deaths, while PCV13+(2*PPSV23) averted 18 IPD cases, 4,380 CAP cases and 533 deaths compared to NV. The estimated medical cost under the NV scenario was approximately 9.2 million, while with PCV20 it was 7.1 million and with PCV13+(2*PPSV23) it was 7.4 million. Vaccination cost differs substantially, with PCV20 it was 13.4 million and with PCV13+(2*PPSV23) 23.8 million. The incremental cost-effectiveness ratio (ICER) of PCV20 vs. NV was 775 USD per QALY, and the ICER of PCV13+(2*PPSV23) vs. NV was 1,824 USD per QALY, figures below the one-GDP-per-capita WTP threshold (6,939 USD).
CONCLUSIONS: PCV20 represented the most efficient strategy, representing a lesser cost per QALY. PCV20 could substantially mitigate the health-economic burden of pneumococcal diseases, being a cost-effective strategy compared to NV and providing a lower ICER than the PCV13+(2*PPSV23) scheme in adults aged ≥65 years from the healthcare system perspective.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE139
Topic
Economic Evaluation
Disease
Vaccines