Table 3. Regional model outputs.
| MAPs Administered | DALYs Averted (for MAPs additional DALYs averted vs baseline) | Disease Management Costs (in thousand US$) | Vaccination Costs (excluding MAP commodity costs; in thousand US$) | ICER, US$ per DALY averted (MAP procurement price = US$1.65 per dose) | ICER, US$ per DALY averted (MAP procurement price = US$3.30 per dose) | ICER, US$ per DALY averted (MAP procurement price = US$5.00 per dose) | |
|---|---|---|---|---|---|---|---|
| All LMICs (80 countries, 80.1 million births) | |||||||
| Baseline (MDV+SDV) | -- | 1,538,536 (1,224,957; 1,868,764) | 399,541 (287,497; 541,512) | 163,807 (136,555; 203,261) | -- | -- | -- |
| +1% additional coverage with MAPs | 49,162 (43,425; 55,272) | 2,468 (1,936: 3,116) | 398,795 (287,021; 540,606) | 163,955 (136,714; 203,425) | -154.44 (-242.33; -86.88) | -119.64 (-204.17; -52.48) | -88.65 (-171.22; -15.44) |
| +1% additional and 1% replacement coverage with MAPs | 194,369 (184,273; 204,183) | 3,476 (2,785: 4,398) | 398,507 (286,803; 540,317) | 163,966 (136,808; 203,421) | -132.86 (-222.07; -59.75) | -41.04 (-126.66; 40.51) | 54.40 (-34.88; 152.73) |
| +1% additional and 5% replacement coverage with MAPs | 773,426 (746,364; 799,418) | 7,552 (5,952: 9,643) | 397,357 (286,139; 539,162) | 163,647 (136,855; 202,958) | -101.92 (-205.27; -9.78) | 64.17 (-41.07; 179.19) | 233.64 (115.71; 386.49) |
| +1% additional and 10% replacement coverage with MAPs | 1,498,144 (1,446,550; 1,546,363) | 12,640 (9,818: 16,240) | 395,919 (285,373; 537,718) | 163,427 (136,590; 202,456) | -92.77 (-205.03; 11.27) | 98.03 (-16.26; 233.87) | 296.78 (161.09; 478.89) |
| AFR (8 countries, 3.8 million births) | |||||||
| Baseline (MDV+SDV) | -- | 56,064 (42,854; 72,258) | 15,481 (10,792; 22,087) | 10,476 (9,155; 12,243) | -- | -- | -- |
| +1% additional coverage with MAPs | 2,225 (1,986; 2,496) | 101 (75: 133) | 15,453 (10,773; 22,053) | 10,494 (9,171; 12,257) | -92.16 (-201.47; -13.73) | -55.50 (-166.86; 30.24) | -21.66 (-130.07; 69.32) |
| +1% additional and 1% replacement coverage with MAPs | 10,113 (9,640; 10,613) | 153 (114: 199) | 15,438 (10,767; 22,030) | 10,487 (9,175; 12,249) | -80.72 (-191.15; 0.08) | 22.29 (-87.26; 130.40) | 133.02 (20.54; 272.46) |
| +1% additional and 5% replacement coverage with MAPs | 41,561 (40,107; 43,061) | 353 (257: 459) | 15,378 (10,736; 21,937) | 10,479 (9,162; 12,227) | -76.88 (-197.17; 42.21) | 122.57 (-15.35; 288.8) | 321.83 (155.66; 560.81) |
| +1% additional and 10% replacement coverage with MAPs | 80,966 (78,115; 83,722) | 604 (431: 782) | 15,330 (10,687; 21,821) | 10,483 (9,155; 12,201) | -70.32 (-200.06; 59.17) | 154.30 (0.56; 341.24) | 382.78 (191.32; 660.72) |
| AMR (20 countries, 9.5 million births) | |||||||
| Baseline (MDV+SDV) | -- | 55,751 (44,875; 70,713) | 16,497 (11,809; 22,240) | 22,192 (17,804; 27,614) | -- | -- | -- |
| +1% additional coverage with MAPs | 3,147 (2,184; 4,035) | 40 (27: 57) | 16,487 (11,798; 22,220) | 22,196 (17,819; 27,629) | 93.85 (-25.57; 194.95) | 222.93 (91.97; 344.21) | 346.32 (205.57; 502.34) |
| +1% additional and 1% replacement coverage with MAPs | 16,271 (14,997; 17,658) | 65 (49: 87) | 16,481 (11,791; 22,210) | 22,202 (17,808; 27,609) | 196.69 (-34.35; 447.40) | 608.14 (351.50; 933.75) | 1055.11 (722.42; 1475.02) |
| +1% additional and 5% replacement coverage with MAPs | 68,722 (66,041; 71,660) | 165 (128: 220) | 16,456 (11,771; 22,161) | 22,204 (17,793; 27,586) | 314.96 (-101.21; 767.71) | 993.27 (530.40; 1583.73) | 1706.78 (1169.13; 2466.75) |
| +1% additional and 10% replacement coverage with MAPs | 134,390 (129,618; 139,527) | 290 (221: 385) | 16,424 (11,749; 22,105) | 22,169 (17,809; 27,482) | 346.49 (-132.48; 847.81) | 1095.57 (576.46; 1787.89) | 1898.83 (1286.29; 2783.89) |
| EMR (9 countries, 8.0 million births) | |||||||
| Baseline (MDV+SDV) | -- | 60,047 (49,532; 73,416) | 16,658 (11,939; 22,503) | 19,030 (16,129; 22,450) | -- | -- | -- |
| +1% additional coverage with MAPs | 5,461 (4,814; 6,057) | 110 (88: 139) | 16,626 (11,916; 22,458) | 19,047 (16,149; 22,469) | -24.53 (-121.47; 64.16) | 55.96 (-37.94; 150.66) | 140.42 (41.43; 246.41) |
| +1% additional and 1% replacement coverage with MAPs | 20,532 (19,501; 21,624) | 155 (124: 193) | 16,610 (11,909; 22,438) | 19,052 (16,144; 22,457) | 26.43 (-81.50; 156.53) | 247.93 (136.74; 408.11) | 478.51 (333.37; 674.99) |
| +1% additional and 5% replacement coverage with MAPs | 80,819 (77,872; 83,878) | 328 (258: 419) | 16,563 (11,877; 22,359) | 19,044 (16,107; 22,421) | 113.17 (-62.67; 325.57) | 515.96 (320.31; 813.31) | 947.82 (686.60; 1345.57) |
| +1% additional and 10% replacement coverage with MAPs | 156,143 (150,592; 161,987) | 542 (417: 702) | 16,511 (11,832; 22,277) | 19,067 (16,130; 22,391) | 139.50 (-65.10; 396.23) | 616.13 (376.28; 977.36) | 1122.17 (810.35; 1594.06) |
| EUR (17 countries, 4.3 million births) | |||||||
| Baseline (MDV+SDV) | -- | 39,047 (30,369; 48,171) | 10,976 (7,741; 15,549) | 20,043 (16,270; 24,527) | -- | -- | -- |
| +1% additional coverage with MAPs | 176 (103; 262) | 10 (6: 15) | 10,971 (7,738; 15,543) | 20,044 (16,272; 24,528) | -117.37 (-222.77; -39.29) | -86.94 (-190.94; -9.02) | -55.03 (-158.45; 26.80) |
| +1% additional and 1% replacement coverage with MAPs | 9,112 (8,689; 9,476) | 82 (62: 106) | 10,955 (7,724; 15,518) | 20,041 (16,283; 24,528) | -139.88 (-296.74; 31.38) | 50.19 (-109.37; 234.74) | 244.49 (68.00; 464.31) |
| +1% additional and 5% replacement coverage with MAPs | 44,682 (42,947; 46,292) | 362 (282: 477) | 10,871 7,668; 15,415) | 20,051 (16,355; 24,458) | -137.89 (-307.21; 43.56) | 63.41 (-102.56; 262.89) | 277.65 (85.67; 527.47) |
| +1% additional and 10% replacement coverage with MAPs | 89,172 (85,774; 92,350) | 716 (555: 943) | 10,762 (7,592; 15,273) | 20,090 (16,340; 24,362) | -137.67 (-308.18; 47.74) | 65.94 (-102.28; 266.47) | 283.02 (88.47; 533.51) |
| SEAR (8 countries, 32.0 million births) | |||||||
| Baseline (MDV+SDV) | -- | 593,396 (482,632; 710,357) | 151,496 (111,808; 164,622) | 38,584 (32,995; 46,052) | -- | -- | -- |
| +1% additional coverage with MAPs | 44,990 (41,208; 48,437) | 1,637 (1,313: 2,026) | 151,135 (111,511; 164,544) | 38,756 (33,144; 46,224) | -118.41 (-214.19; -52.10) | -73.21 (-164.25; -3.40) | -26.26 (-115.66; 44.98) |
| +1% additional and 1% replacement coverage with MAPs | 94,104 (89,158; 98,851) | 1,870 (1,529: 2,305) | 151,088 (111,459; 164,243) | 38,756 (33,128; 46,191) | -99.13 (-194.04; -32.52) | -13.67 (-106.97; 54.72) | 69.39 (-21.79; 148.59) |
| +1% additional and 5% replacement coverage with MAPs | 290,264 (279,364; 300,658) | 2,859 (2,322: 3,587) | 150,899 (111,252; 163,298) | 38,703 (33,076; 46,092) | -55.98 (-158.18; 17.41) | 108.76 (5.68; 210.32) | 281.17 (161.13; 410.26) |
| +1% additional and 10% replacement coverage with MAPs | 534,737 (516,682; 553,714) | 4,103 (3,230: 5,207) | 150,663 (110,993; 162,011) | 38,611 (33,033; 45,936) | -36.38 (-140.73; 49.63) | 181.71 (57.77; 308.33) | 412.14 (257.81; 578.75) |
| WPR (18 countries, 22.6 million births) | |||||||
| Baseline (MDV+SDV) | -- | 464,860 (368,293; 569,978) | 119,310 (87,269; 164,622) | 61,059 (48,822; 76,622) | -- | -- | -- |
| +1% additional coverage with MAPs | 2,288 (1,760; 3,022) | 229 (166: 312) | 119,260 (87,226; 164,544) | 61,062 (48,829; 76,635) | -210.88 (-312.10; -138.05) | -192.44 (-293.77; -121.80) | -174.36 (-274.86; -104.83) |
| +1% additional and 1% replacement coverage with MAPs | 48,072 (46,177; 50,051) | 889 (699: 1,119) | 119,101 (87,115; 164,243) | 61,041 (48,849; 76,579) | -179.82 (-280.96; -99.09) | -89.17 (-185.74; -0.15) | 1.48 (-92.79; 96.61) |
| +1% additional and 5% replacement coverage with MAPs | 230,093 (222,998; 238,518) | 3,455 (2,734: 4,444) | 118,464 (86,582; 163,298) | 60,950 (48,914; 76,433) | -174.85 (-277.08; -82.50) | -67.69 (-162.62; 39.86) | 49.94 (-56.02; 167.89) |
| +1% additional and 10% replacement coverage with MAPs | 457,631 (443,864; 474,500) | 6,660 (5,232: 8,549) | 117,542 (85,850; 162,011) | 60,845 (49,108; 76,315) | -173.83 (-278.00; -78.72) | -63.58 (-158.48; 45.77) | 59.05 (-49.61; 180.21) |
Negative ICERs indicate cost-savings over the cohort lifetime. Parenthesised uncertainty the Interquartile Range (IQR) of 1000 model simulations. All costs presented in 2020 US$.
Abbreviations: AFR: African WHO Region, AMR: American WHO Region, DALY: Disability Adjusted Life Year, EMR: Eastern Mediterranean WHO Region, EUR: European WHO Region, ICER: Incremental Cost-Effectiveness Ratio (US$ per DALY averted), LMIC: Low-and middle-income country, MAP: Microarray Patch, MDV: Multiple Dose Vial, SDV: Single Dose Vial, SEAR: Southeast Asian WHO Region, US$: United States Dollars, WHO: World Health Organization, WPR: Western Pacific WHO Region
Data for individual LMICs available in the S1 File.