OBJECTIVES: In Turkey, a 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in a pediatric national immunization program (NIP) in 2011. To further prevent the residual pneumococcal disease (PD), a 20-valent PCV (PCV20) is pending marketing authorization in Turkey. The study aims to estimate clinical and economic impact of replacing PCV13 with PCV20 in NIP.

METHODS: A decision-analytic Markov model was adapted to assess the health and economic impacts of switching from PCV13 to PCV20 in the Turkish infants over a 10-year period. Inputs on disease incidence (i.e., invasive pneumococcal disease [IPD], pneumonia, otitis media [OM]), serotype distribution, direct medical and indirect non-medical costs were mainly derived from local reports and published studies. Costing data were inflated to 2024 values in Turkish Lira. Direct and indirect vaccine effect estimates were determined by clinical efficacy, effectiveness, and impact studies of PCV13 and PCV7. Health and economic outcomes were discounted at a rate of 3% per annum.

RESULTS: Compared with PCV13, PCV20 was estimated to avert additional 10,305 IPD cases, 229,883 pneumonia cases, 1.4 million OM cases, and 7,097 PD deaths over 10 years. By preventing additional pneumococcal disease (PD) cases, PCV20 would save ₺9.24 billion direct medical cost and ₺4.38 billion indirect cost.

CONCLUSIONS: Replacing PCV13 with PCV20 in the Turkish pediatric NIP would provide significant health and economic impacts as it is expected to prevent more PD cases, avert more deaths due to disease and save more direct medical and indirect costs compared with PCV13.