13-Valent Pneumococcal Conjugate Vaccine Demonstrates Cost-Effectiveness

The 13-valent pneumococcal conjugate vaccine (PCV13) may be cost-effective in adults and children, according to the results of a systematic review published in Taylor & Francis Online.

Pneumococcal diseases (PDs) have become a serious public health problem around the world, contributing to significant morbidity, mortality, and a substantial burden on health care systems.

Given the increasing resistance to antibiotic treatments for Streptococcus Pneumoniae (SPn), the main cause of PDs, there is a need for vaccination for PDs. Although pneumococcal vaccination is known as the most cost-effective measure to prevent infection with SPn, the evidence-based cost-effectiveness of PCV-13 is unclear.

Although studies on economic evaluations of PCV13 had increased over the past decade, no systematic reviews had previously synthesized the evidence from these economic evaluations. The evidence-based cost effectiveness of PCV13 remained unclear, with some study results showing the vaccine to be more cost-effective relative to no vaccine or other pneumococcal vaccines and others showing the vaccine not to be cost-effective.

Therefore, investigators conducted a comprehensive systematic review of cost-effectiveness of PCV13 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review was the first of its kind to include economic evaluations of PCV13 reported in both Chinese and English and conducted in a variety of countries. A total of 44 studies met the inclusion criteria to be included in the review. Narrative synthesis was used to summarize the findings of the individual studies.

The findings supported the economic advantages of the PCV13 vaccination in adults and children. Vaccination with PCV13 was found to significantly reduce the morbidity and mortality of pneumococcal diseases.

Evidence indicated that PCV13 was cost-effective compared with no vaccine or several other pneumococcal vaccines. Among the 44 studies, the results of most showed that PCV13 inoculation was cost-effective. However, 6 showed what PCV13 was not cost-effective, though these studies were targeted at children. The results from just 1 study showed that PCV13 inoculation was unlikely to be cost-effective among adults.

Countries are reevaluating the economic evaluations and impact of PCV13 vaccination programs, because of pressure from constrained health budgets, the authors noted.

Overall, the systematic review suggests that the PCV13 vaccine is cost-effective in adults and children from the perspective of health care providers, payers, and society. These results provide evidence-based information that may assist decision makers in determining whether the PCV13 vaccination is cost-effective and how the vaccination affects the economic budget.

However, the cost-effectiveness results may vary because of cost-effectiveness thresholds across or within countries, differences in health systems, modeling methods, parameters for effectiveness, and the perspective. One limitation of this study is that, because of significant differences across countries in economic levels and epidemic intensity of PDs, the included studies have substantial heterogeneities with respect to the parameters and perspectives used for costs and effectiveness and modeling and time horizon, making the comparability of the results between countries is limited.

Thus, future research is needed to evaluate the cost-effectiveness of PCV13 using dynamic transmission models to better capture and more accurately assess the effect of previous risk of PDs on future health state and vaccine costs, according to the authors.

Reference

Du Y, Wang Y, Zhang T, et al. Economic evaluations of 13-valent pneumococcal conjugate vaccine: a systematic review. Expert Rev. Vaccines. 2023;2(1):193-206. doi:10.1080/14760584.2023.21