Table 1.
Parameter values used in cost-effectiveness modeling
| Parameter | Base case | Range | Source |
|---|---|---|---|
| Probabilities | % | % | |
| Vaccination probability with no program | |||
| Influenza | 66 | 36–74 | (4) |
| Tdap | 25 | 4–54 | (4) |
| Pneumococcal vaccines | 71 | 31–81 | (4) |
| Absolute increase in vaccine uptake with program | |||
| Influenza | 5 | 0–15 | (4) |
| Tdap | 10 | 0–26 | (4) |
| Pneumococcal vaccines | 10 | 0–18 | (4) |
| Vaccine effectiveness | |||
| Influenza | 59.0 | 20–67 | (7–9) |
| Tdap (10 year average) | 24.5 | 0–95 | (10) |
| Pneumococcal vaccines (10 year average) | |||
| Vaccine type invasive pneumococcal disease (IPD) | 54.2 | 40–68 | (12) |
| Vaccine type non-bacteremic pneumonia (NPP) | 38.3 | 28–48 | (11, 12) |
| Pneumococcal illness serotype prevalence | |||
| PCV13 serotypes | 30.7 | 0–50 | (13) |
| PPSV serotypes | 67.6 | 50–85 | (13) |
| Probability of illness without vaccinations (yearly) | |||
| Influenza | 9.0 | 6.6–11.4 | (22) |
| Pertussis | 0.257 | 0.138–0.464 | (23) |
| Invasive pneumococcal disease | 0.023 | 0.0046–0.073 | (24) |
| Non-bacteremic pneumococcal pneumonia | 3.78 | 0.54–12.1 | (24) |
| Relative likelihood of outpatient treatment (vs. inpatient) | 83.1 | 70–96 | (24) |
| Case-hospitalization, influenza | 4.21 | 1.4–7 | (22) |
| Case-mortality, influenza | 1.17 | 0.37–2 | (22) |
| Pertussis severity relative likelihood | |||
| Mild | 14 | 8–20 | (14) |
| Relative likelihood of treatment (vs. no treatment) | 70.7 | 50–90 | (14) |
| Moderate | 74 | 63–85 | (14) |
| Severe (hospitalized) | 12 | 6–18 | (14) |
| Encephalopathy, given severe | 1.43 | 0–3 | (14) |
| Mortality, given severe | 0.86 | 0–2 | (14) |
| Costs (base year 2015) | US$ | US$ | US$ |
| Vaccines | |||
| Influenza | 10.69 | 6.64–32.75 | (25) |
| Tdap | 37.55 | 20.18–42.61 | (25) |
| Pneumococcal polysaccharide | 7.89 | 2.66–13.00 | (25) |
| Pneumococcal conjugate | 15.96 | 9.61–22.00 | (25) |
| Vaccine administration, per vaccine | 25.51 | 20–30 | (26) |
| Implementation program, per eligible person | 1.78 | 0.70–2.26 | a |
| Illness costs | |||
| Mild pertussis, when treated | 305 | 153–1525 | (14) |
| Moderate pertussis | 424 | 212–2120 | (14) |
| Severe pertussis | 7,824 | 4,000–11,500 | (14) |
| Influenza (average, all severities) | 1,655 | 432–3,706 | (22) |
| Pneumococcal disease (average, all severities) | 3,422 | 671–16,056 | (24) |
| Utilities, disutilities, and durations | |||
| Utilities | |||
| Pertussis | |||
| Mild | 0.9 | 0.8–0.99 | (14) |
| Moderate | 0.85 | 0.75–0.95 | (14) |
| Severe | 0.81 | 0.6–0.9 | (14) |
| Encephalopathy | 0.2 | 0–0.4 | (14) |
| Non-bacteremic pneumococcal pneumonia | |||
| Inpatient | 0.2 | 0–0.5 | (12) |
| Outpatient | 0.9 | 0.7–1 | (27) |
| Invasive pneumococcal disease | 0.2 | 0.0.5 | (12) |
| Disability post pneumococcal disease | 0.4 | 0.2–0.6 | (12) |
| Disutilities (quality adjusted life years lost) | QALY | QALY | QALY |
| Non-hospitalized influenza | 0.0021 | 0–0.02 | (22) |
| Hospitalized influenza | 0.042 | 0.02–0.08 | (22) |
| Illness death (discounted) | 10.25 | 5–15 | (28) |
| Illness duration (days) | |||
| Pertussis | 87 | 30–100 | (14) |
| Non-bacteremic pneumococcal pneumonia | |||
| Inpatient | 27 | 20–40 | (27) |
| Outpatient | 18 | 10–25 | (27) |
| Invasive pneumococcal disease | 27 | 20–40 | (27) |
a
Calculation from unpublished 4 Pillars data