Table 4. Incremental cost effectiveness of pneumococcal vaccination in Kenya and sensitivity analysis of the impact of indirect effects for PCV10 and PCV13.

	Vaccine costs(US $)	Treatment costs (US $)	Net costs(US $)	Pneumococcal cases	Pneumococcal deaths	Discounted DALYs	Cost (US$) per case averted (95% CI)	Cost per (US$)per deathaverted (95% CI)	Cost (US$) per DALY averted (95% CI)
Base case(0–59 month old children only and no indirect effects)
No pneumococcal vaccination	17,100,167	4,578,815	21,678,982	93,217	13,947	459,145
With PCV10	31,137,435	2,609,271	33,746,705	53,629	7,831	256,301
Increment	14,037,764	−1,969,545	12,067,723	39,588	6,116	202,844	300 (145–488)	1,958 (913–3,425)	59 (26–103)
With PCV13	31,193,391	2,167,382	33,360,773	44,780	6,460	211,052
Increment	14,093,224	−2,411,433	11,681,790	48,437	7,487	248,094	238 (110–390)	1,558 (665–2,764)	47 (20–83)
Indirect effects in the entire population
No pneumococcal vaccination	84,863,269	30,173,792	115,037,061	512,708	102,134	3,957,704
With PCV10	154,916,931	13,854,396	168,771,327	199,064	49,662	2,053,280
Increment	70,053,662	−16,319,396	53,734,266	313,644	52,472	1,904,425	189 (85–320)	1,158 (585–2,225)	32 (14–55)
With PCV13	154,972,887	10,886,054	165,858,941	138,968	40,030	1,729,744
Increment	70,109,618	−19,287,738	50,821,880	373,740	62,104	2,227,960	147 (62–258)	888 (366–1,597)	25 (10–44)

^*All costs, pneumococcal episodes and deaths are discounted at an annual rate of 3%.