In 2010 the US Advisory Committee on Immunization Practices (ACIP) recommended that the pneumococcal seven-valent conjugate vaccine (PCV7) given routinely to children up to two years old be replaced by the pneumococcal thirteen-valent version (PCV13) because of the additional health benefits. Since the new vaccine is more expensive, payers have voiced concerns that these costs could increase health insurance premiums and strain fixed public health agency budgets. A new study, being released as a Web First by Health Affairs, estimated the additional cost of PCV13 use by public and private US insurance payers to be $3.5 billion and $2.6 billion, respectively, over PCV7, between 2010 and 2019.

The authors also found that PCV13 could provide net cost savings of $6.14 billion and $4.24 billion, respectively, to those payers by preventing pneumococcal disease and its associated costs, with another $1.66 billion in savings to be realized for uninsured patients.

For their study model, the authors combined data from clinical trials, the National Immunization Survey, the Centers for Disease Control and Prevention (CDC), and other sources to estimate the cost of the PCV13 vaccine and the savings associated with preventing pneumococcal disease from 2010-19 in 2013 dollars. "This analysis demonstrates that PCV13 is cost saving for both the public and private sectors," concluded the authors. "Nonetheless, budgetary silos within the sectors may create barriers to adequate funding for implementation of the vaccine. As a result, policy makers will face ongoing challenges as they seek to ensure that all Americans have access to effective and efficient protection from infectious diseases."