OBJECTIVES: Brazil does not have pneumococcal vaccine as part of the older adults’ immunization schedule in National Immunization Program (NIP). This study aims to estimate the budget impact of implementing a single dose of 23-valent polysaccharide vaccine (PPSV23) into NIP for adults aged 60 years from the Brazilian public payer perspective.

METHODS: A previous Excel-based cohort budget impact model with a 5-year time horizon (2022-2026) was adapted for Brazil. Disease states included: no pneumococcal disease, Invasive Pneumococcal Disease (IPD), non-bacteremic pneumococcal pneumonia (NBPP), post-meningitis sequelae and death. The target population of 60-year-olds were divided into healthy (58%), at risk (32%) and high-risk (10%). Budget impact was calculated by comparing no vaccination (current market) to PPSV23 implementation (future scenario). As the initial cohort aged, new populations were added to the target age cohort and costs/disease cases were calculated cumulatively. We assumed a future market share scenario of 100% (vaccine coverage) for every year of analysis. Costs were converted to US dollars (1US$=5.14R$).

RESULTS: For a cohort of 2.1 million 60-year-olds, direct costs for treatment in the current market with no vaccination was $8 million over a 5-year time horizon. With PPSV23 implementation, over 5-years, the health system will reduce cost of $1.8 million in direct medical costs. Direct medical costs increased with an average of $22 million per year to a total budget impact of $112 million after 5 years. This cost is largely explained by vaccine and administration costs.

CONCLUSIONS: Given the previously defined market share, a larger budget impact is not expected than the one presented. However, depending on the observed vaccine effectiveness and NBPP incidence, budget impact can be much lower than the projected. Implementing PPSV23 will demand additional investments and should be part of the healthy aging policy agenda for countries with accelerated aging populations like Brazil.