Cost effectiveness sensitivity
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Contents
Question
The effects of alternative vaccine compositions on the outcomes of the cost-effectiveness analysis were assessed. Five modifications for PCV10 and one for PCV13 were considered.
Answer
Conclusion: The assumption about serotype 3 in PCV13 is crucial. In addition, assumptions about the role of 6A in PCV10 is important.
If serotype 3 is not included as a vaccine type in PCV13, then the differences between PCV10 and PCV13 in IPD (shown below), quality adjusted life years gained (not shown) and medical costs (not shown) are relatively minor. Therefore, if the vaccine price is equal for PCV10 and PCV13, then in view of the intrinsic uncertainties in the model, PCV10 and PCV13 can be regarded as roughly equally cost-effective.
Rationale
Three separate tables are displayed, each corresponding to a different quantity.
The three quantities of interest are:
*PCV13adv.inIPD
= (IPD under PCv10) - (IPD under PCV13)
if positive, PCV13 saves IPD cases compared to PCV10
*price of PCV13
= if PCV10 price set at 20e, what is the matching price for PCV13?
*ICER
= incremental cost-effectiveness ratio for PCV10 at price 20e
(in this table, this value is also average cost per QALY)
rows (vaccine composition PCV10 and its 5 modifications): [1] pcv10 [2] pcv10 + 19A(direct effects only) [3] pcv10 + 6A [4] pcv10 + 19A(direct only) + 6A [5] pcv10 + 19A(full) [6] pcv10 + 19A(full) + 6A = PCV13 - 3 columns (vaccine composition PCV13 with or without serotype 3): [1] pcv13 - 3 (excluding serotype 3) [2] pcv13
PCV13adv.inIPD price of PCV13 ICER
============== ============== ===============
PCV13-3 PCV13 PCV13-3 PCV13 PCV13-3 PCV13
--- --- ------- ----- ----- ----
pcv10 12 150 18 38 8077 8077
pcv10+19Ad -2 134 17 37 7714 7714
pcv10+6A 50 188 25 55 13590 13590
pcv10+19Ad+6A 32 169 24 52 12724 12724
pcv10+19Af -31 105 15 32 6198 6199
pcv10+19Af+6A * 137 * 43 * 9672
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(PCV10 price=20)
See also
