OBJECTIVES: Assess the cost-effectiveness of a single dose of 20-valent pneumococcal conjugate vaccine (PCV20) versus sequential administration of sequential administration of PCV15 followed by pneumococcal polysaccharide vaccine (PPV23) in the adult population of Argentina.

METHODS: A Markov-type model was adapted to simulate the lifetime risk of clinical and economic outcomes (i.e., invasive pneumococcal disease (IPD), all-cause nonbacteremic pneumonia (NBP), and associated costs) in a hypothetical population of adults aged 18 years and older in Argentina using a Healthcare System perspective. Outcomes were projected for each person based on age, risk profile, vaccination status, vaccine type, and time since vaccination. Vaccine price for PCV15 and PCV20 were assumed the same as for PCV13 and equal to $19.80 (values corresponding to Ministry of Health tender price 2022), the price for PPV23 was $8.63 (values corresponding to Panamerican Health Organization). Incremental cost per life year gained (LYG) and per quality adjusted life years (QALY) gained were estimated. Costs and future benefits were discounted 3% annually. Unit costs are expressed in 2021 US-Dollars.

RESULTS: From a payer's perspective, PCV20 results in a dominant strategy compared to PCV15+PPV23. The model estimated that PCV20 reduces bacteremia cases by 681, all-cause NBP by 7,305 and deaths due to acute disease by 780. Medical costs were reduced by $6.96M and vaccination costs by $19.83M for the PCV20 strategy.

CONCLUSIONS: From a healthcare perspective PCV20 could be a dominant strategy compared to PCV15+PPV23 in Argentina. PCV20 would avert more cases of IPD, all-cause NBP and deaths with a higher number of LYG and QALYs at a lower cost.