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The cost-effectiveness acceptability frontier depicts the strategy with the highest expected net benefit for a given willingness to pay threshold. The no vaccination strategy has the highest expected net benefit at values of ≤$35,000/QALY, PCV13 substituted for PPSV23 in current recommendations is favored from $40,000-50,000/QALY, and PCV13 at ages 50 and 65 is favored at higher willingness to pay thresholds >$50,000/QALY.
