Cost-effectiveness analysis of 13-valent pneumococcal conjugate vaccine versus 23-valent pneumococcal polysaccharide vaccine in an adult population in South Korea

• Published in: Human vaccines & immunotherapeutics 2018-01, Vol.14 (8), p.1914-1922
• Main Authors: Choi, Min-Joo, Kang, Shin-On, Oh, Jin-Jeong, Park, Seong-Beom, Kim, Min-Ja, Cheong, Hee-Jin
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cost-Benefit Analysis; cost-effectiveness analysis; Female; Humans; Incidence; Korea; Male; Mass Vaccination - economics; Mass Vaccination - methods; Middle Aged; PCV13; pneumococcal vaccination; Pneumococcal Vaccines - administration & dosage; Pneumococcal Vaccines - economics; Pneumonia, Pneumococcal - economics; Pneumonia, Pneumococcal - epidemiology; Pneumonia, Pneumococcal - microbiology; Pneumonia, Pneumococcal - prevention & control; PPSV23; Quality-Adjusted Life Years; Republic of Korea - epidemiology; Research Paper; Streptococcus pneumoniae; Streptococcus pneumoniae - immunology; Treatment Outcome; Vaccines, Conjugate - administration & dosage; Vaccines, Conjugate - economics; Young Adult
• ISSN: 2164-5515; 2164-554X
• DOI: 10.1080/21645515.2018.1456602

In South Korea, the National Immunization Program offers a 23-valent pneumococcal polysaccharide vaccine (PPSV23) for the elderly; however, the 13-valent pneumococcal conjugate vaccine (PCV13) is not included, and vaccination is not offered to younger, at-risk populations. This study offers a comparative analysis of PCV13 and PPSV23 in Korea's adults, stratified by age and risk group. A Markov model with a lifetime horizon was developed from the healthcare perspective. Data sources included the Health Insurance Review & Assessment Service, Korea Centre for Disease Control & Prevention and Korean medical institutions. An expert panel tested data validity. The CAPiTA trial and Cochrane meta-analysis were used to obtain vaccine effectiveness data. Regardless of co-morbidity, when the sequential PCV13-PPSV23 strategy was compared to that using PPSV23-only, in elderly populations, the incremental cost-effectiveness ratio (ICER) was 3,300 USD per quality-adjusted life years (QALY). For the risk group aged ≥65 years, the ICER of the addition of PCV13 over the existing PPSV23-only strategy was 3,404 USD/QALY. However, on replacing PPSV23 with PCV13, for all elderly populations, an ICER of 1,421 USD/QALY resulted; for the risk group aged ≥65 years, the ICER was 1,736 USD/QALY. For the 18-64 year-old risk group, the sequential PCV13-PPSV23 strategy yielded an ICER of 3,629 USD/QALY over the PPSV23-only strategy, and 6,643 USD/QALY compared to no vaccination. Thus, the PCV13→PPSV23 combination strategy for elderly populations was found to be a cost-effective alternative to the current National Immunization Program regardless of co-morbidity. This finding was the same as that for younger, at-risk populations.