OBJECTIVES: The aim of the present study was to evaluate the cost-effectiveness of 20-valent pneumococcal conjugate vaccine (PCV20) compared to 13-valent pneumococcal conjugate vaccine (PCV13) and 15-valent pneumococcal conjugate vaccine (PCV15) for prevention of pneumococcal disease in pediatric population in Greece.

METHODS: A published decision-analytic Markov model was adapted from payer perspective, to compare PCV20 (under a 3+1 dosing schedule) versus PCV13 and PCV15 (both under a 2+1 dosing schedule) over a 10-year time horizon. Epidemiological data, serotype coverage, vaccines’ effectiveness, utility, and direct medical costs (prices €, 2024) inputs were obtained from published literature and official sources. Model outcomes included number of invasive pneumococcal disease (IPD), non-invasive hospitalized pneumonia, non-hospitalized pneumonia and otitis media (OM) cases, attributable deaths, costs, quality-adjusted life-years (QALY) for each vaccination strategy and incremental cost-effectiveness ratio.

RESULTS: The base case analysis indicated that, vaccination with PCV20 compared to PCV13 and PCV15 prevents an additional 1,953 and 1,514 cases of IPD, 54,956 and 42,069 non-invasive hospitalized and non-hospitalized pneumonia cases, 343,353 and 271,864 OM cases and 1,377 and 987 deaths respectively, resulting in incremental gain of 23,065 and 17,118 QALYs respectively. The lower number of pneumococcal disease cases with PCV20 compared to PCV13 and PCV15, translated to a reduction in total medical care cost of approximately €249 million versus PCV13 and approximately €192 million compared with PCV15 over the modelled time horizon.

CONCLUSIONS: PCV20, providing a broader serotype coverage, is estimated to improve public health by averting additional pneumococcal disease cases and deaths relative to PCV15 and PCV13 and translates to cost-savings for the public payer. Overall results showed that vaccination with PCV20 was estimated to be a dominant vaccination strategy (improved health outcomes with reduced costs) over PCV15 or PCV13 for prevention of pneumococcal disease in Greek infants.