Perdrizet Johnna, Ta An, Huang Liping, Wannaadisai Warisa, Ilic Aleksandar, Hayford Kyla, Sabra Ayman
Global Health Economics and Outcomes Research, Pfizer Canada, Kirkland, QC, Canada.
, Cytel, UK.
Infect Dis Ther. 2025 Mar;14(3):501-525. doi: 10.1007/s40121-025-01108-3. Epub 2025 Feb 3.
Despite the approval of a 20-valent pneumococcal conjugate vaccine (PCV20) for pediatric use in many regions globally, integration of PCV20 into national immunization programs (NIPs) is delayed in some countries. We explored the public health and economic benefits forfeited by postponing transitions from lower-valent pneumococcal conjugate vaccines (PCVs) to PCV20.
A targeted literature review (TLR) identified modeling studies comparing the public health and economic impact of PCV20 versus 13-valent PCV (PCV13) or 15-valent PCV (PCV15) in pediatric NIPs. Only studies with accessible models underwent data extraction and analysis. Foregone public health (pneumococcal disease cases/disease-related deaths) and economic (medical/non-medical costs) outcomes, defined as the projected incremental differences between the outcomes associated with PCV20 and lower-valent PCVs, were calculated over 2 years following PCV20 implementation (per year and month). Discount rates for all outcomes were adjusted to 0% given the short time horizon and for consistency across analyses.
The TLR identified models from 13 countries globally. The monthly health benefits forgone due to delayed transitions from PCV13 to PCV20 ranged between 40 (Slovakia) and 1740 (Canada) pneumococcal disease cases averted in the first year of delay across populations, increasing by between 1.5 (Sweden) and 15-16 times (Germany and Mexico) in the second year. Forgone cumulative disease-related deaths averted ranged from 18 (Spain) to 2657 (Germany) and forgone cumulative direct medical cost-savings ranged from 930 thousand Euros (Portugal) to 146 million Euros (Germany) due to delayed transitions from PCV13 to PCV20 over 2 years. Similar, but slightly reduced, benefits were forfeited with delayed transitions from PCV15 to PCV20.
Delays in implementing PCV20 into pediatric NIPs were projected to have substantial negative public health and economic consequences. These results underscore the necessity for national immunization technical advisory groups, policymakers, health organizations, and manufacturers to accelerate replacement of lower-valent standard-of-care PCVs with PCV20.
尽管20价肺炎球菌结合疫苗（PCV20）已在全球许多地区获批用于儿科，但在一些国家，将PCV20纳入国家免疫规划（NIP）的工作有所延迟。我们探讨了推迟从低价比肺炎球菌结合疫苗（PCV）过渡到PCV20所丧失的公共卫生和经济效益。
通过有针对性的文献综述（TLR），确定了比较PCV20与13价PCV（PCV13）或15价PCV（PCV15）在儿科NIP中的公共卫生和经济影响的模型研究。只有模型可获取的研究才进行数据提取和分析。计算了在PCV20实施后的2年里（每年和每月）所丧失的公共卫生（肺炎球菌病病例/疾病相关死亡）和经济（医疗/非医疗成本）结果，定义为与PCV20和低价比PCV相关的结果之间的预计增量差异。鉴于时间跨度较短且为了分析的一致性，所有结果的贴现率均调整为0%。
TLR确定了全球13个国家的模型。因从PCV13推迟过渡到PCV20而每月丧失预防的肺炎球菌病病例数在第一年延迟期间，不同人群中从40例（斯洛伐克）到1740例（加拿大）不等，在第二年增加了1.5倍（瑞典）到15 - 16倍（德国和墨西哥）。因从PCV13推迟过渡到PCV20，在2年里所丧失预防的累积疾病相关死亡数从18例（西班牙）到2657例（德国）不等，所丧失的累积直接医疗成本节省从93万欧元（葡萄牙）到1.46亿欧元（德国）不等。从PCV15推迟过渡到PCV20会丧失类似但略少的效益。
预计将PCV20纳入儿科NIP的延迟会产生重大的负面公共卫生和经济后果。这些结果强调了国家免疫技术咨询小组、政策制定者、卫生组织和制造商加快用PCV20替代低价比标准护理PCV的必要性。
