Table 3. Incremental cost-effectiveness ratios and threshold analyses with and without herd-immunity against serogroup AWY.

	ICER a [€/QALY (95% CI)]		Threshold incidence per 100,000 persons for €50,000/QALY
	Base case incidence a	2011 incidence b		Base case c	2011 scenario d
No herd-immunity against AWY
MenACWY vs MenC	c.s. (c.s.-c.s.)	c.s. (c.s.-c.s.)		N.A.	N.A.
MenACWY+MenACWY vs MenC
Waning rate booster 0.04	635,334 (259,672–1,121,856)	473,398 (179,847–849,293)		1.53	0.98
No waning booster	367,978 (151,968–649,963)	307,743 (114,982–554,719)		0.91	0.65
MenACWY+MenACWY vs MenACWY
Waning rate booster 0.04	988,490 (440,833–1,675,575)	621,307 (251,868–1,089,972)		2.37	1.28
No waning booster	518,405 (224,848–887,791)	396,431 (160,174–700,855)		1.28	0.83
MenACWY+MenACWY vs MenACWYe
Waning rate booster 0.04	c.s. (c.s. −3,168)	c.s. (c.s. −2,908)		N.A.	N.A.
No waning booster	c.s. (c.s. −3,269)	c.s. (c.s. −2,867)		N.A.	N.A.
Herd-immunity against AWY
MenACWY+MenACWY vs MenC
Waning rate booster 0.04	247,279 (101,873–426,876)	204,170 (76,617–365,845)		0.61	0.43
No waning booster	190,073 (75,665–331,131)	163,264 (59,144–293,917)		0.48	0.35
MenACWY+MenACWY vs MenACWY
Waning rate booster 0.04	359,264 (166,041–593,227)	268,094 (110,297–466,305)		0.87	0.56
No waning booster	267,157 (119,263–447,724)	212,846 (84,860–372,550)		0.66	0.45

QALY = quality adjusted life year, c.s. = cost-saving, N.A. = not applicable.

^aBase case incidence (average 2007–2011): 0.10 cases of serogroup A,W135,Y and 0.05 cases of serogroup C per 100,000 persons.

^b2011 incidence: 0.11 cases of serogroup A,W135,Y and 0.02 cases of serogroup C per 100,000 persons.

^cUsing the average age-distribution of the serogroup A,C,W135 and Y incidence of 2007–2011.

^dUsing the age-distribution of the serogroup A,C,W135 and Y incidence of 2011.

^eScenario analysis: compared with MenACWY at 14 months with only direct effects of vaccination and the incidence of C of 2001: 2.09 cases of serogroup C per 100,000 persons.