Cost-utility of pneumococcal strategies for adults aged 50 and older in Colombia: a model-based economic evaluation

This study evaluates the cost-utility of different pneumococcal vaccination strategies for adults aged 50 years and older in Colombia using a decision-tree model. The analysis compares six vaccination strategies (including PCV13, PCV15, PCV20, and combinations with PPSV23) against no vaccination, incorporating local epidemiological data, costs, and quality-adjusted life years (QALYs) over 5- and 10-year horizons.

Key findings

• PCV20 had the highest probability (73.4%) of being the most cost-effective strategy at a willingness-to-pay threshold of one GDP per capita.
• PCV20 prevented the largest number of cases, deaths, and complications, including an estimated 1,427 deaths averted over the model horizon.
• PCV13 and PCV20 were cost-effective at both 5- and 10-year time horizons, while other strategies became cost-effective only over longer horizons.
• PPSV23 alone was not cost-effective, showing limited health benefits relative to its cost.
• In scenario analyses including complications (e.g., cardiovascular events and antimicrobial resistance), PCV20 and PCV13 became cost-saving strategies.
• Results were robust across sensitivity analyses, with vaccine cost, serotype coverage, and disease incidence identified as key drivers.

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