OBJECTIVES: Streptococcus pneumoniae (or pneumococcus) infections are still important causes of morbidity and mortality. In 2015, despite the decrease in the burden of pneumococcal disease due to the use of conjugate vaccines, an estimated 393,000 deaths worldwide in children under 5 years old were due to pneumonia. The aim of this analysis is to compare utility and costs between 13-valent pneumococcal conjugate vaccine versus the 10-valent for children under five years old.

METHODS: A cost-utility analysis was developed, with a decision tree modeling, considering local data for the prevalence of invasive pneumococcal disease (IPD) and pneumonia, and data from the literature for effectiveness of the evaluated technologies, for the incorporation the use of PCV13 in the Brazilian public healthcare system. The model simulates a cohort of newborns vaccinated at birth with PCV13 or PCV10. Each year, a new cohort with the same characteristic is vaccinated, up to a five-year horizon. Effectiveness measures were QALY (quality-adjusted life years), LY (years of life lost), and number of events prevented (DPI) and pneumonia.

RESULTS: The analysis showed that the average cost saving of using the PCV13 vaccine was -R$ 121,054,625.60, translated into an incremental effectiveness of 164 QALYs over five years. The incremental cost-effectiveness ratio was dominant at - BRL 737,368.53/QALY.

CONCLUSIONS: The clinical evidence and the favorable result of the cost-utility analysis for PCV13, are consistent with the current WHO recommendation, published in 2019, which highlights that the choice of a type of vaccine in a country it must consider the conditions of the vaccination program, guarantee of supply, prices sustainable to the local reality, the local prevalence of the serotypes and the pattern of antimicrobial resistance of these serotypes. In this context, the data presented in analysis may contribute to justify the expansion of the use of PCV13.