Cost-effectiveness analysis of 20-valent pneumococcal conjugate vaccine for routine pediatric vaccination programs in Japan

ABSTRACT

Background

The Japanese National Immunization Program currently includes the pediatric 13 valent pneumococcal conjugate vaccine (PCV13) to prevent pneumococcal infections. We aimed to evaluate the cost-effectiveness of 20-valent PCV (PCV20) as a pediatric vaccine versus PCV13.

Methods

A decision-analytic Markov model was used to estimate expected costs, quality-adjusted life-years (QALYs), and prevented cases and deaths caused by invasive pneumococcal disease, pneumonia, and acute otitis media over a ten-year time horizon from the societal and healthcare payer perspectives.

Results

PCV20 was dominant, i.e. less costly and more effective, over PCV13 (gained 294,599 QALYs and reduced Japanese yen [JPY] 352.6 billion [2.6 billion United States dollars, USD] from the societal perspective and JPY 178.9 billion [USD 1.4 billion] from the payer perspective). Sensitivity and scenario analyses validated the robustness of the base scenario results. When comparing PCV20 with PCV13, the threshold analysis revealed an incremental cost-effectiveness ratio that was within the threshold value (JPY 5 million/QALY) at a maximum acquisition cost of JPY 74,033 [USD 563] (societal perspective) and JPY 67,758 [USD 515] (payer perspective).

Conclusions

As a pediatric vaccine, PCV20 was dominant over PCV13 regardless of the study perspective.

KEYWORDS:

• Cost-effectiveness
• Japan
• PCV20
• pneumococcal disease
• vaccination

Declaration of interest

M Shinjoh has no relevant affiliations or financial involvement with any other organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. However, outside this study, M Shinjoh has received speaking honoraria from Meiji Seika Pharma Co., Ltd., Shionogi & Co., Ltd., MSD K.K., FUJIREBIO Inc., Mitsubishi Tanabe Pharma Corporation, Taisho Pharmaceutical Co., Ltd., FUJIFILM Toyama Chemical Co., Ltd., The Mainichi Newspapers Co., Ltd., Maruho Co., Ltd., Astellas Pharma Inc., Sumitomo Pharma Co., Ltd., Daiichi Sankyo Co., Ltd., Takeda Pharmaceutical Co., Ltd., Japan Vaccine, a consultation fee from Pfizer Japan Inc., and grant support from JSPS KAKENHI, Japan (Grant Number JP20K10546, 2020–2023), none of which was in connection with the work presented here. K Togo, N Yonemoto, T Hayamizu, and K Kamei are employees of Pfizer Japan Inc. J Morii is an employee of IQVIA Solutions G.K., and J Perdrizet is an employee of Pfizer Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All the authors (M Shinjoh, K Togo, T Hayamizu, N Yonemoto, J Morii, J Perdrizet, K Kamei) (1) made substantial contributions to the study concept or the data analysis or interpretation, (2) drafted the manuscript or revised it critically for important intellectual content, (3) approved the final version of the manuscript to be published, and (4) agreed to be accountable for all aspects of the work.

Ethical approval

This study used publicly available or anonymized data; therefore, ethical approval was not required.

Acknowledgments

The authors thank Dr. Ataru Igarashi of Yokohama City University School of Medicine and The University of Tokyo for providing valuable scientific advice. Medical writing support was provided by Anshika Singhal and Saurabh Trikha of IQVIA, India, and was funded by Pfizer Japan Inc. The analysis was supported by Des Dillon-Murphy and Ruth Chapman of Evidera. A claims database analysis was supported by Masashi Mikami of Pfizer Japan Inc. Yawen Dai of IQVIA Solutions G.K. assisted with data collection and the literature review.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article or its supplemental materials.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2024.2345670

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by Pfizer Japan Inc.