An economic evaluation of pneumococcal conjugate vaccination (PCV) in China finds that introducing PCV13 into provincial childhood immunization programs in Qinghai and Hainan could substantially cut disease burden while remaining good value for money. Using a decision tree–Markov model, researchers estimate that a three-dose PCV13 schedule delivered at National Immunization Program (NIP)–level coverage (98.9%) could avert around 7,100 pneumococcal disease episodes and 118 deaths in Qinghai, and 6,200 episodes and 66 deaths in Hainan, compared with current limited, privately financed use of PCV.
From a societal perspective, the study finds that PCV13 is cost-effective even at the prevailing private-sector price of US$68.20 per dose, with incremental cost-effectiveness ratios of roughly US$1,135 per QALY in Qinghai and US$4,597 per QALY in Hainan—well within commonly cited thresholds for upper-middle-income settings. At a UNICEF-like price of US$25 per dose, the program becomes cost-saving in both provinces, and scenarios with more modest coverage levels (50–75%) also remain cost-effective. Sensitivity analyses highlight vaccine price and underlying disease burden as key drivers but do not overturn the main conclusion: prioritizing PCV13 in subnational immunization programs can improve child health and promote health equity in under-served provinces, offering important evidence for China’s ongoing discussions on whether and how to bring PCV into publicly funded schedules.
Thumbnail image credit: Shutterstock / Dmitrii Iakimov
Any organization or individual working in the field of immunization economics can submit findings, opportunities, calls to action, or other relevant work below to be shared with our community.