A systematic review of findings and assumptions of cost-effectiveness analyses of the recently introduced 15- and 20-valent pneumococcal conjugate vaccines (PCV) in adults found that that 20-valent PCV used alone is likely to be cost-effective or dominate other adult pneumococcal strategies. Of 137 identified records, 26 studies were included; the majority concerning high-income countries. All employed static Markov-type models comparing higher-valent PCVs used alone or in combination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) to current recommendations (PPSV23 alone, PCV13 alone, PCV13 + PPSV23, no vaccination). Most studies concluded PCV20 used alone was cost-saving (dominant) or cost-effective compared to other adult pneumococcal strategies.
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