Kazakhstan PCV20 Switch Projected to Save Costs

A new decision-analytic study published in Cost Effectiveness and Resource Allocation projects that transitioning Kazakhstan’s pediatric national immunization program from its current 13-valent pneumococcal conjugate vaccine to a 20-valent version would significantly reduce the burden of pneumococcal disease while lowering overall healthcare costs. The research, led by Thea Paoula Nassar and colleagues, evaluates the public health and economic implications of adopting the 20-valent pneumococcal conjugate vaccine, abbreviated as PCV20, within the country’s existing immunization framework. The study specifically assesses the cost-effectiveness of this switch compared to the currently used 13-valent vaccine, known as PCV13, and the 10-valent vaccine, referred to as PCV10-SII, which is also registered in the region.

Kazakhstan has implemented the 13-valent pneumococcal conjugate vaccine with a 2 + 1 dosing schedule in its pediatric National Immunization Program since 2010. Despite these efforts, the burden of pneumococcal disease persists. A 10-valent PCV is registered and licensed in a 3 + 0 dosing schedule. Recently, a 20-valent PCV was approved for infants aged six weeks and older, available in either a 2 + 1 or 3 + 1 schedule. This study focuses on the economic and health outcomes of switching to this newer, broader-spectrum vaccine, specifically analyzing the impact of delaying its introduction in the national program.

The researchers employed a decision-analytic Markov model to estimate the cost-effectiveness of PCV20 versus PCV13 and PCV10-SII from a payer perspective. Costs and outcomes in the model were discounted at an annual rate of 5.0%. The vaccine effectiveness parameters for PCV20 were derived from clinical effectiveness and impact studies of PCV13, as well as efficacy studies of the earlier PCV7 vaccine. Epidemiologic and cost inputs were shared with Pfizer or sourced from publications relevant to Kazakhstan.

The results of the model indicate substantial benefits associated with the transition to PCV20. Compared to the current PCV13 regimen with a 2 + 1 schedule, implementing PCV20 with a 2 + 1 schedule over a 10-year period was projected to avert 196,509 cases of pneumococcal disease and 5,127 deaths. This scenario was also associated with total cost savings of 108,701 million tenge. If PCV20 were implemented with a 3 + 1 schedule, the model projected the averting of 203,102 disease cases and 5,231 deaths, with total cost savings of 42,754 million tenge. These figures suggest that the broader protection offered by PCV20 translates into significant reductions in disease incidence and mortality, alongside financial benefits for the healthcare system.

When compared to the 10-valent PCV10-SII with a 3 + 0 schedule, the benefits of PCV20 were even more pronounced. The model projected that PCV20 with a 2 + 1 schedule would avert 575,768 pneumococcal disease cases and 14,561 deaths over the same 10-year horizon. The 3 + 1 schedule for PCV20 was projected to avert 590,086 cases and 14,869 deaths. In both comparisons, PCV20 was associated with a higher quality-adjusted life year gain and a lower cost than both PCV13 and PCV10-SII.

The robustness of these findings was tested through sensitivity and scenario analyses, which assess how variations in input parameters affect the results. The study found that the conclusions remained robust under these variations, indicating that the projected benefits of PCV20 are not highly sensitive to changes in key assumptions.

The study also highlights the negative consequences of delaying the implementation of PCV20 in Kazakhstan’s pediatric national immunization program. The authors conclude that a two-year delay in introducing PCV20 would result in negative public health and economic outcomes.

Implementing PCV20 in Kazakhstan’s National Immunization Program could substantially reduce the burden of pneumococcal disease and associated healthcare costs, delivering greater public health and economic impact. The study provides strong evidence that the transition to a 20-valent vaccine is a cost-effective strategy that offers superior protection compared to current options.

Subject of Research: Cost-effectiveness of transitioning to a 20-valent pneumococcal vaccine in Kazakhstan's pediatric national immunization program

Article Title: Public health and economic impact of transitioning to a 20-valent pneumococcal vaccine in Kazakhstan’s pediatric national immunization program

Article References: Nassar, T. P., Tuyakbayeva, K., Shaimagambetova, A., Bizhanova, Z., Struch, S., Chaplinkiy, D., & Huang, L. (2026). Public health and economic impact of transitioning to a 20-valent pneumococcal vaccine in Kazakhstan’s pediatric national immunization program. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-026-00836-8

Image Credits: AI Generated

DOI: 10.1186/s12962-026-00836-8

Keywords: pneumococcal vaccine, PCV20, cost-effectiveness, Kazakhstan, immunization program, public health, health economics, Markov model, pediatric health, vaccine policy, Public, health