THE COST-EFFECTIVENESS OF THE 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE IN CHINESE CITIES

The 13-valent pneumococcal conjugate vaccine (PCV13) offers protection against 13 pneumococcal serotypes, reducing the incidence of invasive pneumococcal disease (IPD), pneumonia, and otitis media (OM). This study estimates the cost-effectiveness of immunization of PCV13 in select Chinese cities. We localized a previously published cost-effectiveness model comparing PCV13 to no vaccination to Beijing, Shanghai, Suzhou, Chengdu, Karamay, Qingdao, and Shenzhen. A systematic literature review (SLR) through 10/11/2019 was undertaken to identify previously published PCV cost-effectiveness models in China. The SLR was utilized to identify sources for estimating the age-specific incidence of pneumococcal bacteremia, pneumococcal meningitis, pneumonia, and OM. Sources identified in the literature review were combined with data from the CHIRA database (2013-2015) to estimate incidence rates. Age-specific direct healthcare costs for each health state were sourced directly from the CHIRA database (2013-2015) and available for Tier 1 cities and nationally. The base case analysis considered a vaccination rate of 85%, herd effect, a 5% discount rate, and took a payer perspective. The number of IPD, pneumonia, and OM cases avoided due to PCV13 vaccination in each city ranged from 13 to 581, 1,039 to 43,769, and 174 to 7,112, respectively. Deaths avoided ranged 18 to 1,061 (1 to 29 for IPD and 17 to 1,032 for pneumonia), which resulted in 275 to 15,134 additional quality-adjusted life-years for PCV13 vaccination compared to no vaccination. The incremental total direct costs of the PCV13 vaccination program ranged between ¥5,462,884 and ¥156,224,157 in the included cities. The incremental cost-effectiveness ratio for PCV13 compared to no vaccination for each city was between ¥1,300 and ¥19,684 per QALY gained, below 1xGDP per capita of each city. PCV13 can be considered highly cost-effective when compared to no vaccination at a vaccination rate of 85% in Beijing, Shanghai, Suzhou, Chengdu, Karamay, Qingdao, and Shenzhen.