COST-UTILITY OF REPLACING PCV13 WITH PCV20 IN THE COSTA RICAN PEDIATRIC IMMUNIZATION PROGRAM: A HEALTHCARE PERSPECTIVE ANALYSIS
Author(s)
Jair A. Arciniegas, MSc1, Andreina Jose Alamo, BSc2, Rolando Ulloa, MD3, Olga Arguedas, MD4, María Ávila-Agüero, MD4, Jorge LaRotta, MD5, Jaime Ordoñez, MEd, PhD6, Juan José Baldi-Castro, MSc, PharmD7, Leo Alejandro Barrantes, Pharm7, Juan Manuel Reyes, MSc8.
1Value & Evidence Coordinator, Pfizer SAS, Bogotá, Colombia, 2PFIZER COLOMBIA, Bogota, Colombia, 3Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica, 4Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”; Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica, 5Pfizer Colombia, Bogotá, Colombia, 6TrueConsulting, MEDELLIN, Colombia, 7Pfizer CAC, Escazú, Costa Rica, 8Pfizer SAS, Bogotá, Colombia.
1Value & Evidence Coordinator, Pfizer SAS, Bogotá, Colombia, 2PFIZER COLOMBIA, Bogota, Colombia, 3Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica, 4Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”; Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica, 5Pfizer Colombia, Bogotá, Colombia, 6TrueConsulting, MEDELLIN, Colombia, 7Pfizer CAC, Escazú, Costa Rica, 8Pfizer SAS, Bogotá, Colombia.
OBJECTIVES: To assess the cost-utility of updating the pneumococcal vaccination recommendation with PCV20 in the pediatric population from the Costa Rican healthcare system perspective.
METHODS: A cohort-based Markov model was adapted to compare PCV20 against PCV13, the current standard of care, for the pneumococcal disease prevention in pediatric population, both administered using a 2+1 schedule. PCV20 and PCV13 are the only additional conjugated technologies available at the PAHO revolving fund. Ten annual birth cohorts were modelled over a 10-year period. Health benefits (summarized as quality-adjusted life years [QALY]) and direct medical costs were discounted at 5% from the Costa Rican healthcare perspective. A 96.2% uptake was assumed based on historical national coverage. Epidemiological and effectiveness inputs were obtained from published literature and national databases. Costs were sourced from Costa Rican repositories, and vaccine acquisition costs from PAHO. Costs were reported in 2025 USD.
RESULTS: Over the studied time horizon, PCV20 led to avert 21 IPD cases, 1,131 non-invasive hospitalized pneumonia cases, 1,750 outpatient pneumonia cases, 937 otitis media cases and 8 deaths. These epidemiological benefits translated into 229 additional QALYs. The direct medical costs ascended to 501.3 million with PCV13, while they were located at 494.2 million under the PCV20 schedule. In addition, the cost of sequalae were about 23.2 million and 22.1 million, respectively. Although vaccine acquisition costs were higher with PCV20 (USD 25.0 million vs USD 18.1 million), these were offset by reductions in disease-related expenditures. These findings indicate that PCV20 represents a dominant strategy compared with PCV13. Sensitivity analysis was conducted and confirmed the consistency of the results.
CONCLUSIONS: Replacing PCV13 with PCV20 in Costa Rica is expected to reduce pneumococcal disease burden, prevent deaths, increase QALYs, and generate healthcare cost savings. The broader serotype coverage of PCV20 makes it a cost-saving and health-improving vaccination strategy for the pediatric population.
METHODS: A cohort-based Markov model was adapted to compare PCV20 against PCV13, the current standard of care, for the pneumococcal disease prevention in pediatric population, both administered using a 2+1 schedule. PCV20 and PCV13 are the only additional conjugated technologies available at the PAHO revolving fund. Ten annual birth cohorts were modelled over a 10-year period. Health benefits (summarized as quality-adjusted life years [QALY]) and direct medical costs were discounted at 5% from the Costa Rican healthcare perspective. A 96.2% uptake was assumed based on historical national coverage. Epidemiological and effectiveness inputs were obtained from published literature and national databases. Costs were sourced from Costa Rican repositories, and vaccine acquisition costs from PAHO. Costs were reported in 2025 USD.
RESULTS: Over the studied time horizon, PCV20 led to avert 21 IPD cases, 1,131 non-invasive hospitalized pneumonia cases, 1,750 outpatient pneumonia cases, 937 otitis media cases and 8 deaths. These epidemiological benefits translated into 229 additional QALYs. The direct medical costs ascended to 501.3 million with PCV13, while they were located at 494.2 million under the PCV20 schedule. In addition, the cost of sequalae were about 23.2 million and 22.1 million, respectively. Although vaccine acquisition costs were higher with PCV20 (USD 25.0 million vs USD 18.1 million), these were offset by reductions in disease-related expenditures. These findings indicate that PCV20 represents a dominant strategy compared with PCV13. Sensitivity analysis was conducted and confirmed the consistency of the results.
CONCLUSIONS: Replacing PCV13 with PCV20 in Costa Rica is expected to reduce pneumococcal disease burden, prevent deaths, increase QALYs, and generate healthcare cost savings. The broader serotype coverage of PCV20 makes it a cost-saving and health-improving vaccination strategy for the pediatric population.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE445
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Vaccines