Cost-Effectiveness of Conjugate Pneumococcal Vaccines in At-Risk Adults Aged 18 to 64 Years

Key Messages

• Eight economic evaluations (6 peer-reviewed, 2 summarized in a single grey literature source) assessing the cost-effectiveness of pneumococcal conjugate vaccines in adults aged 18 to 64 years at high risk of invasive pneumococcal disease (IPD) in high-income countries were identified.
  • The 2 economic evaluations summarized in the single grey literature source were industry-sponsored analyses. A version of the results was previously summarized by the Public Health Agency of Canada. As such, the methods and results of the industry-funded models are only summarized in Appendix 3 for this review.
  • None of the peer-reviewed studies identified assessed the cost-effectiveness of pneumococcal 15-valent conjugate vaccine (PCV15), pneumococcal 20-valent conjugate vaccine (PCV20), or pneumococcal 21-valent conjugate vaccine (PCV21).
  • Of the peer-reviewed studies, 2 were conducted in the US, 2 in South Korea, 1 in Spain, and 1 in Hong Kong. All results were presented in terms of incremental cost-effectiveness ratios (ICERs) (i.e., incremental cost per quality-adjusted life-years gained).
    •  Four studies concluded that 1 dose of pneumococcal 13-valent conjugate vaccine (PCV13) was cost-effective relative to either no vaccination, 2 doses of PCV13, PCV13 plus 2 doses of pneumococcal polysaccharide 23-valent vaccine (PPSV23), or 2 doses of PPSV23.
    • Two studies concluded that PCV13 plus PPSV23 was cost-effective relative to either no vaccination or 1 dose of PPSV23, but the studies did not evaluate the cost-effectiveness of PCV13 alone.
    • The studies did not all consider the same vaccination strategies.
  • The sources used to parameterize vaccine effectiveness in the peer-reviewed studies are highly uncertain, as the clinical evidence was either not representative of the target population or heavily reliant on expert input and assumptions.
• The generalizability of the economic evaluations may be limited because the study settings were notably different from Canada. To estimate the potential cost-effectiveness of pneumococcal conjugate vaccines in Canada, a de novo economic evaluation conducted from a setting is Canada is required.