OBJECTIVES

Pneumococcal conjugate vaccines (PCVs) protect against pneumococcal disease caused by Streptococcus pneumoniae bacteria. We conducted a systematic literature review of the cost-effectiveness of PCVs within Mainland China.

METHODS

A systematic literature review was undertaken to identify economic evaluations of PCV in Mainland China through 10/11/2019. The search string of ”pneumococc* AND conjugat* AND (vaccin* OR immun*) AND “economic OR cost-effectiveness OR cost-benefit OR cost-utility’ was used in the MEDLINE and EMBASE databases. Studies with economic evaluations on a national level in Mainland China were included while those not published in English or published prior to 1/1/2006 were excluded. Study characteristics, model inputs (clinical and economic), clinical outcomes, economic outcomes, and cost-effectiveness results were extracted from each study.

RESULTS

There were 7 studies identified, which contained 10 separate analyses comparing pneumococcal vaccination strategies. All analyses compared vaccination (PCV7 = 5; PCV10 = 1; PCV13 = 4;) to no vaccination. Of the 10 analyses, 80.0% (n=8) considered the vaccine to be cost-effective. All PCV10 and PCV13 analyses were considered cost-effective and three of the five PCV7 vs. no vaccination analyses were cost-effective. In studies evaluating more than one vaccine, vaccines with a higher valency had lower ICERs than vaccines with a lower valency when compared to no vaccination. The included studies utilized decision tree (n=5) and Markov models (n=2), were funded by non-industry (n=4) and industry (n=3), and took payer (n=4) and societal (n=4) perspectives. The incidence data for IPD, pneumonia, and otitis media utilized in the models were from a variety of sources and included CHIRA, Taiwan’s National Health Insurance Research Database, network meta-analysis, and surveillance studies in the literature.

CONCLUSIONS

PCVs were found to be cost-effective against no vaccination in Mainland China. Incremental cost-effectiveness ratios for higher valent vaccines against no vaccination were mostly lower than lower valent vaccines.