Economic Evaluation of Pneumococcal Vaccination in Egypt: Cost-Effectiveness, Budget Impact, and Domestic Manufacturing Potential

This peer-reviewed article evaluates the cost-effectiveness, budget impact, and return on investment of introducing pneumococcal conjugate vaccines (PCVs) in Egypt using a deterministic age-structured dynamic transmission model over a 20-year horizon. The analysis compares immediate versus delayed introduction, alternative PCV10-to-PCV13 pathways, and domestic manufacturing scenarios, incorporating both direct and indirect (herd immunity) effects across all age groups. 

Key findings 

• Immediate PCV13 introduction is projected to avert 38.5 million cases and 139,451 deaths over 20 years
• The intervention is highly cost-effective, with an ICER of $523 per DALY averted (0.16× GDP per capita)
• Annual programme costs are estimated at ~$124.9 million without Gavi support and ~$120.9 million with support
• Return on investment is high (≈23), reflecting substantial economic benefits from reduced disease burden
• Delaying introduction reduces deaths averted by ~30% (5-year delay) and ~61% (10-year delay)
• Alternative pathways (PCV10 followed by PCV13) achieve similar health outcomes with lower budget impact and higher ROI
• Vaccine price and uptake are the main drivers of cost-effectiveness and budget impact outcomes

Thumbnail image credit: Gavi