For adults, pneumococcal vaccination may be more cost-effective with the 13-valent conjugate, formerly reserved for children (Prevnar 13), than with the currently recommended 23-valent version (Pneumovax 23), according to a modeling study.

The cost per quality life-year gained was estimated at $28,900 with the 13-serotype vaccine (PCV13) compared with $34,600 with the 23-serotype polysaccharide vaccine (PPSV23), said Kenneth J. Smith, MD, of the University of Pittsburgh, and colleagues.

Those numbers were in the range considered to be moderately good evidence for adoption of an intervention, although changing some assumptions about efficacy of the newer vaccine eliminated its advantage, the group reported in the Feb. 22/29 issue of the Journal of the American Medical Association.

"PCV13 might prevent more pneumococcal disease compared with current PPSV23 vaccination recommendations while remaining economically reasonable," they concluded.

The conjugate vaccine covers the 13 bacterial serotypes that account for most invasive pneumonia. It replaced the seven-valent version used for children in 2010 and gained an expanded indication for the 50 and older population just last month.