OBJECTIVES: Currently in South Korea, National Immunization Program (NIP) offers 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23) in order to prevent pneumococcal diseases among the over-65 elderly population; however, 13-Valent Pneumococcal Conjugate Vaccine (PCV13) is not included in the program. This study proffers a comparative analysis of PCV13 versus PPSV23 for Korean adult population.

METHODS: Analysis was designed in Markov model and from a healthcare perspective for a full life-cycle. Epidemiological and cost data used for analysis, such as incidence and mortality of pneumococcal diseases and serotype coverage, were drawn from Health Insurance Review & Assessment Service’s Big Data, Korea Centre for Disease Control & Prevention reports and research resources from Korean medical institutions. An expert panel was hosted to verify data. The CAPiTA trial and Cochrane meta-analysis for PCV13 and PPSV23 was utilizaed for effectiveness data. The addition of PCV13 to current NIP (PCV13 is followed by PPSV23) was compared to vaccination of PPSV23 only. The analysis was based on 2 types of population classified by co-morbidity (all population vs. risk group) and age groups (18~64, over 65 and over 75 years old)

RESULTS: When the addition of PCV13 vaccination was compared to the vaccination of PPSV23 only for over 65 years old, incremental cost-effectiveness ratio (ICER) turned out to be 3,300 USD per quality-adjusted life years (QALY). For risk group of those over 65 year old, ICER of addition of PCV13 over existing PPSV23-only vaccination was 3,404 USD/QALY. For 18-64yrs risk group, vaccinating both PCV13 and PPSV23 yielded ICER of 3,629 USD/QALY over existing PPSV23. In addition, sequential vaccination of PCV13 and PPSV23 to all elderly population over 75 resulted in ICER of 1,007 USD/QALY.

CONCLUSIONS: The strategy of vaccination sequential vaccination of PCV13 and PPSV23 in all age groups can be interpreted as cost effective from healthcare perspective in Korea.