COST-EFFECTIVENESS OF PCV20 IN ECUADOR IN PEDIATRIC POPULATION: A HEALTHCARE SYSTEM PERSPECTIVE ANALYSIS
Author(s)
Jair A. Arciniegas, MSc1, Andreina Jose Alamo, BSc2, RICARDO YAJAMIN, MSc3, Jorge LaRotta, MD4, Juan Manuel Reyes, MSc5.
1Value & Evidence Coordinator, Pfizer SAS, Bogotá, Colombia, 2PFIZER COLOMBIA, Bogota, Colombia, 3Value Health Economics Group - HEOR & HTA Consulting, QUITO, Ecuador, 4Pfizer, Bogotá, Colombia, 5Pfizer SAS, Bogotá, Colombia.
1Value & Evidence Coordinator, Pfizer SAS, Bogotá, Colombia, 2PFIZER COLOMBIA, Bogota, Colombia, 3Value Health Economics Group - HEOR & HTA Consulting, QUITO, Ecuador, 4Pfizer, Bogotá, Colombia, 5Pfizer SAS, Bogotá, Colombia.
OBJECTIVES: To assess the cost-effectiveness of PCV20 compared to PCV13 in children under 1 year of age for the prevention of pneumococcal diseases in Ecuador.
METHODS: A decision-tree with extended process was used to compare PCV20 vs. PCV13 under the 3+0 schedule over life expectancy. These technologies are the only conjugated options at the PAHO revolving fund and align with local pediatric pneumococcal prevention guidelines. From each intervention branch, the model considers three clinical events: IPD, community-acquired pneumonia (CAP), and acute otitis media (AOM). Each of these clinical conditions can lead to different health outcomes: recovery without sequelae, complications with permanent sequelae (e.g. cochlear implant), or death. Progression through the branches was determined by parameters obtained from scientific literature and national epidemiological databases. The main clinical outcome was life-years, and the economic outcome was direct medical cost, both calculated at a 5% discount rate. Healthcare resource-utilization was obtained from clinical experts and costs were sourced from local databases and regulations. Costs were in 2026 US dollars. Deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: A total of 257,108 children were included in the model, and a 68.8% uptake was modelled. PCV20 led to avert 58 IPD cases, over 1,000 CAP cases, about 175 AOM cases and 10 deaths. These clinical outcomes translate into additional 636 life-years. The direct medical costs with PCV13 were approximately 33.5 million while with PCV20 31.1 million. Vaccination program cost was near to 9.6 million and 13.9 million, respectively. The incremental cost-effectiveness ratio was 2,183 USD per life year gained, below the one-GDP-per-capita WTP threshold (6,939 USD).
CONCLUSIONS: PCV20 provides expanded serotype coverage and was projected to prevent a greater number of pneumococcal disease cases and associated deaths compared to PCV13. The substitution of PCV13 with PCV20 within the Immunization Program represented a cost-effective strategy in Ecuador.
METHODS: A decision-tree with extended process was used to compare PCV20 vs. PCV13 under the 3+0 schedule over life expectancy. These technologies are the only conjugated options at the PAHO revolving fund and align with local pediatric pneumococcal prevention guidelines. From each intervention branch, the model considers three clinical events: IPD, community-acquired pneumonia (CAP), and acute otitis media (AOM). Each of these clinical conditions can lead to different health outcomes: recovery without sequelae, complications with permanent sequelae (e.g. cochlear implant), or death. Progression through the branches was determined by parameters obtained from scientific literature and national epidemiological databases. The main clinical outcome was life-years, and the economic outcome was direct medical cost, both calculated at a 5% discount rate. Healthcare resource-utilization was obtained from clinical experts and costs were sourced from local databases and regulations. Costs were in 2026 US dollars. Deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: A total of 257,108 children were included in the model, and a 68.8% uptake was modelled. PCV20 led to avert 58 IPD cases, over 1,000 CAP cases, about 175 AOM cases and 10 deaths. These clinical outcomes translate into additional 636 life-years. The direct medical costs with PCV13 were approximately 33.5 million while with PCV20 31.1 million. Vaccination program cost was near to 9.6 million and 13.9 million, respectively. The incremental cost-effectiveness ratio was 2,183 USD per life year gained, below the one-GDP-per-capita WTP threshold (6,939 USD).
CONCLUSIONS: PCV20 provides expanded serotype coverage and was projected to prevent a greater number of pneumococcal disease cases and associated deaths compared to PCV13. The substitution of PCV13 with PCV20 within the Immunization Program represented a cost-effective strategy in Ecuador.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE751
Topic
Economic Evaluation
Disease
Vaccines