Pneumococcal Polysaccharide Conjugate Vaccine, 20-Valent
Prevention of pneumococcal disease in non-Indigenous adults aged ≥70 years, Aboriginal and Torres Strait Islander adults aged ≥25 years, and individuals aged ≥18 years with NIP-listed risk conditions.
Access path
- Nov 2022Recommended · restricted
vs 13-valent pneumococcal conjugate vaccine (13vPCV)…
- PBS listing · Restricted
From the public summary
The PBAC recommended that 20-valent pneumococcal conjugate vaccine (20vPCV, Prevenar 20) be a designated vaccine for the purposes of the National Health Act 1953, for the prevention of pneumococcal disease in individuals with an at-risk condition aged ≥ 18 years, non-Indigenous adults aged ≥ 70 years and Aboriginal and Torres Strait Islander adults aged ≥ 25 years.PSD · Nov 2022
The PBAC considered that nomination of 13vPCV as the main comparator for the existing NIP populations was appropriate. The PBAC accepted 15vPCV as a near market comparator, which was recommended for NIP-listing by the PBAC at the November 2021 meeting but was not listed on the NIP at the time of the 20vPCV consideration. For the expanded population, the PBAC accepted ‘no vaccine’ as the appropriate comparator.PSD · Nov 2022
The type of economic evaluation presented was a cost-utility analysis and a cost- effectiveness analysis. The ESC noted 15vPCV was listed on a cost minimisation basis versus 13vPCV and considered a similar approach would be appropriate for the current NIP populations if the available evidence does not adequately support superiority of 20vPCV over 13vPCV or 15vPCV.PSD · Nov 2022
The key components of the economic evaluation comparing 20vPCV with 15vPCV and 13vPCV is presented in Table 9. Separate Markov models were developed for each of the four target populations. The ESC considered the model structure appropriate, although noted not all sensitivity analyses requested by ATAGI were able to be implemented (see paragraph 6.75).PSD · Nov 2022
• 20vPCV has equivalent efficacy against IPD and PP to 13vPCV for the shared serotypes and superior efficacy against IPD and PP for the additional 7 serotypes.PSD · Nov 2022
• 20vPCV has equivalent efficacy against IPD and PP to 15vPCV for the shared serotypes and superior efficacy against IPD and PP for the additional 5 serotypes.PSD · Nov 2022
The PBAC noted and welcomed the input from a consumer group/organisation (1) via the Consumer Comments facility on the PBS website. The PBAC noted Lung Foundation Australia was supportive of the listing of 20vPCV on the NIP for the prevention of pneumococcal disease.PSD · Nov 2022
Cost-effectiveness
Cost-minimisation approach used for current NIP populations versus 13vPCV and 15vPCV; ICER values not stated in public document. For expanded population (Aboriginal and Torres Strait Islander adults aged 25-49), cost-effectiveness analysis versus no vaccine presented but specific ICER not disclosed in PSD.
The pre-PBAC response acknowledged in order to address uncertainties related to the clinical superiority of 20vPCV over 13vPCV and 15vPCV as raised during the evaluation of 20vPCV and by the ESC, that the PBAC may make a recommendation using a cost minimisation approach versus 13vPCV and 15vPCV. PSD · 2022
Decision context
PopulationAdults aged 18 years and over at increased risk of pneumococcal disease; non-Indigenous adults aged ≥70 years; Aboriginal and Torres Strait Islander adults aged ≥25 years.
Submission history
| Decided | Outcome | Comparator | ICER | Evidence |
|---|---|---|---|---|
| Nov 2022 | Recommended · restricted | 13-valent pneumococcal conjugate vaccine (13vPCV); 15-valent pneumococcal conjugate vaccine (15vPCV); 'no vaccine' for A | — | RCT · Immunogenicity |
Consumer voice
Lung Foundation Australia expressed support for listing 20vPCV on the NIP for pneumococcal disease prevention, highlighting benefits including an alternative to 13vPCV, reduced disease risk and burden, and strengthened community respiratory health.
The PBAC noted Lung Foundation Australia was supportive of the listing of 20vPCV on the NIP for the prevention of pneumococcal disease. Consumer comments · PSD
Similar precedents
Regulatory · TGA
Label narrower than PBS population — PBAC restricts to adults ≥70 years, Indigenous ≥25 years, or those with specific at-risk conditions; TGA permits all adults ≥18 years.