OBJECTIVES: Streptococcus pneumoniae (Sp) causes pneumococcal disease (PD), which can be prevented through vaccination. In France, a 13-valent vaccine, PCV13, has been recommended for children since 2009. However, a new vaccine, PCV15, targeted against 15 Sp serotypes (two additional serotypes versus PCV13) is recommended since February 2024. This study aimed at evaluating the cost-effectiveness of PCV15 compared to PCV13 for active immunization against invasive PD (IPD), pneumonia, and acute otitis media (AOM) caused by Sp in infants, children, and adolescents in France.

METHODS: A dynamic transmission model (DTM) was adapted to the French settings to estimate the cost-effectiveness of PCV15 versus PCV13 over a 65-year time horizon, from all payers perspective. The model simulated the French population, transmission of Sp, PD epidemiology, vaccination effects, and associated medical costs and quality of life data. Vaccine effectiveness (VE) of PCV15 and PCV13 against IPD was derived using the correlates of protection method validated by WHO and data from international literature. Direct medical costs (€2022) included treatment acquisition, administration and management of PD. Costs and health outcomes were discounted at 2.5% per annum for 30 years, then at 1.5%. Deterministic and probabilistic sensitivity analyses and scenarios analyses were conducted to ensure robustness of results.

RESULTS: Over 65 years, introducing PCV15 could avert 60 443 IPD cases, 1 197 post-meningitis sequelae cases, 428 078 pneumonia cases, 79 453 AOM cases and 11 492 deaths associated with PD compared to PCV13, all ages considered. These results were associated with cost savings of more than €300 million, making PCV15 a dominant strategy against PCV13. Sensitivity analyses confirmed these findings.

CONCLUSIONS: Vaccinating the pediatric population with PCV15 is a cost-effective strategy compared to PCV13 due to its lower costs and better outcomes. The methodology and results of this economic evaluation have been validated by the French National Health Technology Agency (HAS).