Cost-effectiveness analysis of infant universal routine pneumococcal vaccination in Malaysia and Hong Kong

Area of Science:

• Public Health
• Health Economics
• Vaccinology

Background:

• Pneumococcal disease significantly impacts morbidity, mortality, and healthcare costs.
• Infant universal immunization programs using pneumococcal conjugate vaccines (PCV) are effective in reducing disease burden.
• Evaluating the comparative clinical and economic benefits of different PCV valencies is crucial for public health policy.

Purpose of the Study:

• To assess the clinical and economic advantages of PCV13 versus PCV10 in Malaysia and Hong Kong.
• To compare the cost-effectiveness of PCV13 and PCV10 from both payer and societal perspectives.
• To determine the long-term impact of PCV13 and PCV10 on disease reduction and quality-adjusted life years (QALYs).

Main Methods:

• An age-stratified Markov cohort model was utilized for evaluation.
• Country-specific data for Malaysia and Hong Kong were incorporated into the model.
• Incremental cost-effectiveness ratios (ICERs) were calculated to compare vaccination strategies over a 10-year birth cohort.

Main Results:

• PCV13 demonstrated superior public health outcomes, including greater reductions in invasive pneumococcal disease (IPD), pneumonia, and acute otitis media cases, and more lives saved compared to PCV10.
• PCV13 yielded substantial additional QALYs compared to PCV10 in both Malaysia and Hong Kong.
• PCV13 was found to be cost-saving against PCV10 from both payer and societal viewpoints in all analyzed scenarios.

Conclusions:

• PCV13 is a more effective and economically advantageous strategy than PCV10 for infant universal immunization programs.
• The broader serotype coverage and enhanced herd effect of PCV13 are key drivers of its superior performance.
• Implementing PCV13 is recommended for maximizing public health and economic benefits in pneumococcal disease prevention.