OBJECTIVES: To evaluate the cost-effectiveness of single dose PCV20 versus currently recommended adult pneumococcal vaccination regimens in Sweden set by the Public Health Agency.

METHODS: A probabilistic model with a Markov-type process was used to depict lifetime risk and costs of pneumococcal disease in Swedish adults. Epidemiologic parameters, serotype coverage, costs, vaccines effectiveness and coverage were based on published literature or publicly available data. The model population is stratified based on age and risk profile (i.e., low, moderate, or high-risk of disease). Single dose PCV20 is compared to 13-valent pneumococcal conjugate vaccine (PCV13) followed by the 23-valent polysaccharide vaccine (PPV23) for the high-risk group ≥18 years, and versus PPV23 for the moderate risk group 18-64 years, and versus PPV23 in low and moderate risk groups ≥65 years.

RESULTS: Compared to the currently recommended vaccine regimen (PCV13+PPV23) for the high-risk group ≥18 years, PCV20 would prevent an additional 347 and 2,448 cases of invasive pneumococcal disease (IPD) and all-cause nonbacteremic pneumonia (NBP), respectively, as well as 236 disease-related deaths. For the moderate risk group 18-64 years and low and moderate risk groups ≥65 years of age, PCV20 would prevent an additional 2,217 and 43,686 cases of IPD and NBP, respectively, as well as 3,293 disease-related deaths. In all scenarios, both from a healthcare and a societal perspective, PCV20 alone is dominant (i.e., cost-saving) versus comparator vaccine regimens.

CONCLUSIONS: The cost-effectiveness analysis demonstrates that single dose PCV20 is expected to be a cost-saving intervention from both a healthcare and societal perspective in Sweden. Findings also suggest that replacing current regimens with PCV20 alone is anticipated to reduce cases, hospitalizations, and save lives.