OBJECTIVES: To prevent pneumococcal disease, the Dubai Health Authority (DHA) recommends use of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPV23; PCV13→PPV23) among adults aged 19-49 years with underlying medical or immunocompromising conditions (i.e., at-risk and high-risk conditions, respectively) and all adults aged ≥50 years. We evaluated the budgetary impact of novel 20-valent PCV (PCV20) compared with current recommendations among adult patients living in Dubai who have private health insurance coverage.

METHODS: Risks and costs of invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP) were evaluated over a 5-year modeling horizon using a deterministic model. During each year of the modeling horizon, persons in the model population could be vaccinated with PCV20 or PCV13→PPV23, or remain unvaccinated; persons vaccinated during the modelling horizon were not eligible for vaccination in subsequent years. Input values were estimated based on local data, as available, and other published sources, as necessary.

RESULTS: Use of PCV20 (vs. PCV13→PPV23) among at-risk and high-risk non-UAE nationals aged 19-49 years and all non-UAE nationals aged 50-99 years living in Dubai (N=390,536) would prevent 13 cases of IPD, 31 cases of inpatient all-cause NBP, 139 cases of all-cause outpatient NBP, and 5 disease-related deaths over a 5-year period, reducing medical care costs by $0.35 million (i.e., from $51.42M to $51.07M). With vaccination costs lower by $2.08 million, use of PCV20 in lieu of PCV13→PPV23 would yield 5-year cost savings totaling $2.43 million, or $1.25 per person per year.

CONCLUSIONS: The introduction of PCV20 in Dubai private insurance for adult patients who are, per DHA, at elevated risk of pneumococcal disease would reduce cases of IPD, inpatient/outpatient all-cause NBP, and disease-related deaths, and would be cost-saving compared with currently recommended PCV13→PPV23.