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Published on: February 23, 2014
Delayed Transition to 20-Valent Pneumococcal Conjugate Vaccine in Pediatric National Immunization Programs: Forgone
Johnna Perdrizet1, An Ta2, Liping Huang3
1Global Health Economics and Outcomes Research, Pfizer Canada, Kirkland, QC, Canada. Johnna.Perdrizet@pfizer.com.
Insights
Delaying the introduction of the 20-valent pneumococcal conjugate vaccine (PCV20) into national immunization programs forfeits significant public health and economic benefits. Accelerating PCV20 adoption is crucial to prevent pneumococcal disease and associated costs.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- The 20-valent pneumococcal conjugate vaccine (PCV20) is approved for pediatric use, but its integration into national immunization programs (NIPs) is inconsistent globally.
- Delays in PCV20 adoption mean some countries miss out on its benefits compared to lower-valent vaccines like PCV13 and PCV15.
Purpose of the Study:
- To quantify the public health and economic benefits forgone by delaying the transition from lower-valent pneumococcal conjugate vaccines (PCVs) to PCV20 in pediatric NIPs.
- To highlight the consequences of delayed PCV20 implementation.
Main Methods:
- A targeted literature review identified modeling studies comparing PCV20 with PCV13 or PCV15 in pediatric NIPs.
- Accessible models were analyzed to extract foregone public health (disease cases, deaths) and economic (medical costs) outcomes over two years post-implementation.
- A 0% discount rate was applied due to the short time horizon.
Main Results:
- Delayed PCV20 transitions result in substantial forgone health benefits, including hundreds to thousands of pneumococcal disease cases and dozens to thousands of deaths averted monthly.
- Significant economic losses were observed, with millions of Euros in direct medical costs not saved due to delayed PCV20 adoption.
- These forgone benefits were also noted, albeit to a lesser extent, for transitions from PCV15 to PCV20.
Conclusions:
- Postponing PCV20 integration into pediatric NIPs leads to considerable negative public health and economic impacts.
- Accelerated adoption of PCV20 over existing lower-valent vaccines is essential.
- National immunization technical advisory groups, policymakers, and manufacturers should prioritize PCV20 implementation.
Introduction:
Despite the approval of a 20-valent pneumococcal conjugate vaccine (PCV20) for pediatric use in many regions globally, integration of PCV20 into national immunization programs (NIPs) is delayed in some countries. We explored the public health and economic benefits forfeited by postponing transitions from lower-valent pneumococcal conjugate vaccines (PCVs) to PCV20.
Methods:
A targeted literature review (TLR) identified modeling studies comparing the public health and economic impact of PCV20 versus 13-valent PCV (PCV13) or 15-valent PCV (PCV15) in pediatric NIPs. Only studies with accessible models underwent data extraction and analysis. Foregone public health (pneumococcal disease cases/disease-related deaths) and economic (medical/non-medical costs) outcomes, defined as the projected incremental differences between the outcomes associated with PCV20 and lower-valent PCVs, were calculated over 2 years following PCV20 implementation (per year and month). Discount rates for all outcomes were adjusted to 0% given the short time horizon and for consistency across analyses.
Results:
The TLR identified models from 13 countries globally. The monthly health benefits forgone due to delayed transitions from PCV13 to PCV20 ranged between 40 (Slovakia) and 1740 (Canada) pneumococcal disease cases averted in the first year of delay across populations, increasing by between 1.5 (Sweden) and 15-16 times (Germany and Mexico) in the second year. Forgone cumulative disease-related deaths averted ranged from 18 (Spain) to 2657 (Germany) and forgone cumulative direct medical cost-savings ranged from 930 thousand Euros (Portugal) to 146 million Euros (Germany) due to delayed transitions from PCV13 to PCV20 over 2 years. Similar, but slightly reduced, benefits were forfeited with delayed transitions from PCV15 to PCV20.
Conclusion:
Delays in implementing PCV20 into pediatric NIPs were projected to have substantial negative public health and economic consequences. These results underscore the necessity for national immunization technical advisory groups, policymakers, health organizations, and manufacturers to accelerate replacement of lower-valent standard-of-care PCVs with PCV20.
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