Cost-effectiveness analysis of 23-valent pneumococcal polysaccharide vaccine for elderly in Zhejiang province, China

Home > Cost-effectiveness analysis of 23-valent pneumococcal polysaccharide vaccine for elderly in Zhejiang province, China

This peer-reviewed research article, published in Human Vaccines & Immunotherapeutics, evaluates the cost-effectiveness of introducing the 23-valent pneumococcal polysaccharide vaccine (PPV23) for older adults into the provincial immunization program in Zhejiang province, China. Conducted by researchers from the Yinzhou District Center for Disease Control and Prevention and the Zhejiang Provincial Center for Disease Control and Prevention, the study uses a decision tree–Markov model from a societal perspective to compare one-dose PPV23 vaccination (at 90% coverage) versus no vaccination among cohorts aged 60 and 70 years. The model incorporates invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBP), estimates quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs), and applies both one-way and probabilistic sensitivity analyses.

Key findings

  • PPV23 vaccination reduced IPD cases, NBP cases, and deaths in both age cohorts compared to no vaccination.
  • In the 60-year-old cohort, vaccination reduced IPD cases by 9.56% and deaths by 6.72%. In the 70-year-old cohort, reductions were greater: IPD cases decreased by 20.96% and deaths by 15.70%.
  • The ICER was estimated at US$ 635.31 per QALY for the 60-year-old cohort and at US$ 69.36 per QALY for the 70-year-old cohort.
  • Both ICERs were well below the willingness-to-pay threshold of one time the provincial GDP per capita (US$ 19,075.18), indicating cost-effectiveness.
  • Sensitivity analyses showed results were robust; PPV23 had a 100% probability of being cost-effective at the defined threshold.
  • Vaccine price, vaccination service cost, disease incidence, and vaccine effectiveness were key drivers of cost-effectiveness.

How can the findings be used?

These findings provide economic evidence to inform provincial or national decisions on including PPV23 in immunization programs for older adults in China. They also offer parameters and modeling approaches that may support economic evaluations of adult pneumococcal vaccination in similar middle-income settings.

Thumbnail image credit: Shutterstock / Yusnizam Yusof

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