Josephine van Dongen

Chapter 3 86 Scenario ∆ QALY ∆ soc- ietal cost (in mio. €) a ICER (€/ QALY) - Societal perspec- tive ∆ health- care cost (in mio. €) a ICER (€/ QALY)- Health- care payer perspec- tive Induced IS/com- plicated IS cases Induced IS: prevent- ed fatal cases Induced IS: pre- vented hospi- talized cases Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) Mean (95% CI) for an alternative universal vaccination (in baseline: vaccine coverage of 86% & herd immunity & vaccine costs of €75/child) Vaccine coverage 60% & no herd immunity & market price (€135.3/ child) 1480 (730- 2443) 176 (163- 188) 119,191 (70,488- 244,692) 200 (193- 207) 134,920 (80,702- 275,744) 40.8/2.0 1:2.4 (1:1.3- 1:3.8) 1:603 (1:527- 1:678) w.r.t. vaccine cost per child, excluding application costs (in baseline vaccine costs of €75/child) Vaccine costs of €67.5 1907 (1114- 2915) 81 (57-99) 42,304 (23,270- 79,865) 120 (109- 131) 63,048 (39,266- 111,667) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €60.0 1907 (1114- 2915) 64 (40-82) 33,331 (16,809- 64,499) 103 (92-114) 54,075 (33,482- 96,411) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €52.5 1907 (1114- 2915) 46 (23-65) 24,358 (9,958- 49,675) 86 (75-97) 45,102 (27,586- 81,051) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €45.0 1907 (1114- 2915) 29 (6-48) 15,385 (2,750- 34,992) 69 (58-80) 36,129 (21,511- 66,081) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €37.5 1907 (1114- 2915) 12 (-11-31) 6,412 (cs - 21,296) 52 (41-63) 27,156 (15,467- 50,957) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €30.0 1907 (1114- 2915) -5 (-28 - 14) cost-sav- ing (cs - 2,561) 35 (23-45) 18,183 (9,298- 36,179) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €22.5 1907 (1114- 2915) -22 (-46 - -3) cost-sav- ing (cs- cs) 18 (6-28) 9,209 (2,758- 21,476) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Vaccine costs of €15.0 1907 (1114- 2915) -39 (-63 - -21) cost-sav- ing (cs - cs) 0.5 (-11 - 11) 236 (cs – 7,623) 58.4 / 2.8 1:1.8 (1:1.0- 1:2.8) 1:685 (1:603- 1:767) Used abbreviations: CI: confidence interval; cs: cost-saving; (cs-cs): 95%CI limits both cost-sav- ing; IS: intussusception; S.A.: Sensitivity analysis or scenario analysis. a)Note: negative costs are savings b)In the earlier model the assumed hours of work loss for mild cases were: 0.93; 1.36; 0.84 days for ages