PCV10 and PCV13 are not cost-effective in Thailand because GAVI does not cover them (or most other middle income countries).
Both vaccines would be cost effective if the price was lowered by 70-90% of the current market price.
“Most middle income countries such as Thailand, which are not eligible for GAVI support and therefore face potentially substantial financial barriers to PCV implementation, have not yet implemented PCV programs. Cost-effectiveness studies are especially important to inform decision-making in these settings.
This study indicates that, at current pricing, neither PCV10 nor PCV13 would be considered cost-effective in Thailand at either dosing schedule examined, using Thailand’s standard ceiling threshold to assess health interventions. This finding results largely from the relatively high cost of the vaccine (per dose), which is equivalent to 5–6 times Thailand’s daily minimum wage. Our findings also reveal that the vaccine can become cost-effective or even cost-saving if vaccine costs were reduced by around 70–90% of current market prices.”
Kulpeng W, Leelahavarong P, Rattanavipapong W, et al. Cost-utility analysis of 10- and 13-valent pneumococcal conjugate vaccines: Protection at what price in the Thai context? Vaccine. 2013;31(26):2839-2847. doi:10.1016/j.vaccine.2013.03.047.