Table 1.

Characteristic features of chosen economic evaluations.

No.	Author, Year, Country	EE Type	Intervention	Age (Years)	Risk Profile	VC	Clinical Outcome	Model	Time Horizon	Discount Rate	Currency	Perspective	Funding	Health Outcome	SA
1	Igarashi et al., 2021, Japan [41]	CEA	PCV13 vs. No vaccination PPV23 vs. No vaccination PCV13 vs. PPV23	60–64	Immunocompetent Immunocompromised	-	IPD NBPP: in/out	Natural history model	Lifetime	2%	2021 JPY	Payer, Society	Pfizer	QALY, LY, ICER	DSA, PSA
2	Gouveia et al., 2019, Portugal [62]	CEA, CUA	PCV13 vs. No vaccination PCV13 vs. PPV23	≥18	Immunocompetent Immunocompromised	100%	IPD ACP: in/out	Markov	Lifetime	3%	2014 EUR	Society	Pfizer	QALY, LY, ICER	DSA, PSA
3	Ngamprasertchai et al., 2023, Thailand [42]	CEA	PCV13 vs. No vaccination PPV23 vs. No vaccination	≥65	Immunocompetent Immunocompromised	-	IPD NBPP	Markov	Lifetime	3%	2021 USD	Society	Mahidol University	QALY, LY, ICER	DSA, PSA
4	Sun et al., 2021, China [43]	CEA	PPV23 vs. No vaccination	≥60	Immunocompetent: diabetic	-	IPD CAP: in/out	Markov	Lifetime	5%	2013 USD	Healthcare	NTKRPC	QALY, ICER	DSA
5	Wolff et al., 2020, Sweden [44]	CEA	PPV23 vs. No vaccination PCV13 vs. No vaccination	≥65 ≥75	-	75%	IPD pCAP: in/out	Decision tree	5 years	3%	2020 EUR	Healthcare	None	QALY, ICER	DSA
6	Malene B et al., 2023, Norway [56]	CUA	PCV20 vs. PPV23	18–99	Immunocompetent Immunocompromised	75%	IPD NBPP: in/out	Markov	Lifetime	0–39 years: 4% 40–74 years: 3% >75 years: 2%	2022 EUR	Healthcare	Pfizer	QALY, ICER	DSA
7	Choi et al., 2018, South Korea [45]	CEA	PCV13/PPV23 vs. PPV23 PCV13 vs. PPV23	≥65	Immunocompetent immunocompromised	100%	IPD NBPP: in	Markov	Lifetime	3%	2016 USD	Healthcare	Pfizer	QALY, ICER	DSA
8	Olsen et al., 2022, Denmark [57]	CUA	PCV20 vs. PPV23 PCV20/PPV23 vs. PPV23	≥18 ≥65	Immunocompetent Immunocompromised	73%	IPD NBP: in/out	Markov	Lifetime	0–35 years: 3.5% 36–70 years: 2.5% >70 years: 1.5%	2022 EUR	Society	Pfizer	QALY, ICER	DSA, PSA
9	Wateska et al., 2020, USA [46]	CEA	PPV23 vs. No vac	≥65	Immunocompetent Immunocompromised	-	IPD NBPP: in/out	Markov	Lifetime	3%	2014 USD	Healthcare	NIH	QALY, ICER	DSA, PSA
10	Mendes et al., 2022, England [47]	CEA	PCV20 vs. PCV15/PPV23 PCV20 vs.PCV20/PPV23 PCV20 vs. PPV23	≥18	Immunocompetent immunocompromised	-	IPD CAP: in	Markov	Lifetime	3.5%	2019 EUR	Healthcare	Pfizer	LY, QALY	PSA
11	Nymark et al., 2022, Norway [58]	CUA	PPV23 vs. No vaccination	≥65 ≥75	-	75%	IPD pCAP	Decision tree	5 years	4%	2022 EUR	Healthcare	None	QALY	DSA
12	Marbaix et al., 2023, Belgium [59]	CUA	PCV20 vs. No vaccination PCV20 vs. PCV15/PPV23	≥18	Immunocompetent Immunocompromised	15–18%	IPD NBP: in/out	Markov	Lifetime	3%	2023 EUR	Healthcare	Pfizer	QALY, ICER	DSA, PSA
13	Cantarero et al., 2023, Spain [60]	CUA	PCV20 vs. PCV15/PPV23	≥60	Immunocompetent Immunocompromised	17%	IPD NBP: in/out	Markov	10 years	3%	2018 EUR	Healthcare	Pfizer	QALY, LY, ICER	DSA, PSA
14	Polistena et al., 2022, Italy [61]	CUA	PCV20 vs. PCV13 PCV20 vs. PCV15	65–74	Immunocompetent Immunocompromised	-	IPD NBP: in/out	Markov	Lifetime	3%	2022 EUR	Healthcare	Pfizer	QALY	DSA, PSA
15	Smith et al., 2021, USA [48]	CEA	PCV20 vs. PPV23 PCV20/PPV23 vs. PPV23	≥65	Immunocompetent	-	IPD NBPP: in	Markov	Lifetime	3%	2017 USD	Healthcare	NIAID	QALY	DSA, PSA
16	Smith et al., 2022, USA [51]	CEA	PCV20 vs. No vac PCV15/PPV23 vs. No vac	≥65	Immunocompetent Immunocompromised	-	IPD NBPP: in/out	Markov	Lifetime	3%	2017 USD	Healthcare	NIAID	QALY, ICER	DSA, PSA
17	Thorrington et al., 2018, Netherlands [52]	CEA	PPV23 vs. No vac PCV13 vs. No vac	≥60	-	50%	IPD CAP: in	Static model	10 years	4% cost, 1.5% health	2018 EUR	Healthcare	I-Move+, NIHR HPRU	QALY, ICER	-
18	Wateska et al., 2019, USA [53]	CEA	PPV23 vs. PCV13/PPV23 PPV23 vs. PCV13 PPV23 vs. Expanding PPV23 uptake	50–64	Immunocompetent Immunocompromised	-	IPD NBPP	Markov	50 years	3%	2015 USD	Payer	NIAID	QALY	DSA, PSA
19	Boer et al., 2024, Netherlands [54]	CEA	PCV20 vs. No vac x3 PPV23 vs. No vac PCV15 vs. No vac	≥65	-	70%	IPD NBPP: in	Static model	15 years	4%	2021 EUR	Society	Netherlands Ministry of Health, Welfare, and Sport	QALY, ICER	DSA, PSA
20	Restivo et al., 2023, Italy [55]	CEA	PCV15/PPV23 vs. PCV13/PPV23 PCV15/PPV23 vs. PCV20/PPV23 PCV15/PPV23 vs. PCV20 PCV20/PPV23 vs. No vac	≥18	Immunocompetent Immunocompromised	25–65%	IPD NBP: in/out	Markov	Lifetime	3%	2021 EUR	Society	Merck	QALY, LY	DSA, PSA
21	Gourzoulidis et al., 2023, Greece [5]	CEA	PCV20 vs. PCV15 PCV20 vs. PCV15/PPV23	≥18	Immunocompetent Immunocompromised	-	IPD NBP: in/out	Markov	Lifetime	3.5%	2022 EUR	Payer	Pfizer	QALY	DSA, PSA
22	Atwood et al., 2018, Canada [49]	CEA	PCV13/PPV23 vs. PPV23	≥65	Immunocompetent Immunocompromised	-	IPD ACP: in/out	Markov	5 years	5%	2014 CAN	Healthcare	Pfizer	QALY	DSA, PSA
23	Giglio et al., 2022, Argentina [50]	CEA	PCV13/PPV23 vs. PPV23	≥65	Immunocompetent Immunocompromised	85%	IPD: bacteremia Pneumonia: in/out	Markov	10 years	3%	2020 USD	-	Pfizer	LY, ICER	DSA, PSA

Abbreviation: VC: vaccine coverage; NBP: non-bacteremic pneumonia; NBPP: non-bacteremic pneumococcal pneumonia; CAP: all-cause community-acquired pneumonia pCAP: pneumococcal community-acquired pneumonia; in/out: inpatient and outpatient; NTKRPC: National Technology Key Research Program of China; NIH: National Institute of Health; NIAID: National Institute of Allergy and Infectious Diseases; NIHR HPRU: National Institute for Health Research Health Protection Research Unit; No vac: no vaccination; PCV13/PPV23: PCV13 followed by PPV23, PCV15/PPV23: PCV15 followed by PPV23; PCV20/PPV23: PCV20 followed by PPV23, x3 PPV23: three doses of PPV23; SA: sensitivity analysis DSA: deterministic sensitivity analysis; PSA: probabilistic sensitivity analysis.