Table 4. One-way sensitivity analyses comparing EV71 vaccination with no EV71 vaccination at various prices per dose (US Dollars in 2012).
| $2.5 | $5.0 | $10 (9,595)§ | $20 (29,483) § | $30 (49,372) § | $40 (69,260) § |
|---|---|---|---|---|---|
| Incidence ratio of EV71-associated herpangina to EV71-associated HFMD, 0.044–0.11 | |||||
| Cost-saving | Cost-saving | 9,509 ~ 9,647 (-1% ~ 1%) | 29,388 ~ 29,541 (0% ~ 0%) | 49,267 ~ 49,435 (0% ~ 0%) | 69,146 ~ 69,329 (0% ~ 0%) |
| Hospitalization rate of EV71-associated HFMD, ±50% | |||||
| Cost-saving | Cost-saving ~ 264 | 6,605 ~ 12,586 (-31% ~ 31%) | 26,493 ~ 32,474 (-10% ~ 10%) | 46,381 ~ 52,362 (-6% ~ 6%) | 66,270 ~ 72,251 (-4% ~ 4%) |
| Efficacy of vaccination against EV71-associated HFMD and herpangina (full dose 90%-98%, one dose 0–95%)‡ | |||||
| Cost-saving | Cost-saving ~ 457 | 8,727 ~ 11,072 (9% ~ 15%) | 27,827 ~ 32,303 (6% ~ 10%) | 46,926 ~ 53,534 (5% ~ 8%) | 66,026 ~ 74,765 (5% ~ 8%) |
| Rate of mild adverse events after vaccination, 47%-71% | |||||
| Cost-saving | Cost-saving | 9,437 ~ 9,859 (-2% ~ 3%) | 29,325 ~ 29,747 (-1% ~ 1%) | 49,213 ~ 49,636 (0% ~ 1%) | 69,102 ~ 69,524 (0% ~ 0%) |
| Rate of serious adverse events after vaccination, 0–0.1% | |||||
| Cost-saving | Cost-saving | 9,583 ~ 9,613 (0% ~ 0%) | 29,472 ~ 29,501 (0% ~ 0%) | 49,360 ~ 49,389 (0% ~ 0%) | 69,248 ~ 69,278 (0% ~ 0%) |
| Vaccine coverage (first dose 85%-100%, second dose 83%-100%)‡ | |||||
| Cost-saving | Cost-saving | 9,595 ~ 9,597 (0% ~ 0%) | 29,482 ~ 29,496 (0% ~ 0%) | 49,370 ~ 49,396 (0% ~ 0%) | 69,256 ~ 69,295 (0% ~ 0%) |
| Disability weight (encephalitis 0.613–0.616, aseptic meningitis 0.613–0.616) ‡ | |||||
| Cost-saving | Cost-saving | 9,595 ~ 9,595 (0% ~ 0%) | 29,483 ~ 29,484 (0% ~ 0%) | 49,371 ~ 49,373 (0% ~ 0%) | 69,260 ~ 69,261 (0% ~ 0%) |
| Disability weight (pulmonary oedema/hemorrhage 0.201–0.300, myocarditis 0.201–0.300) ‡ | |||||
| Cost-saving | Cost-saving | 9,595 ~ 9,596 (0% ~ 0%) | 29,482 ~ 29,485 (0% ~ 0%) | 49,369 ~ 49,375 (0% ~ 0%) | 69,256 ~ 69,264 (0% ~ 0%) |
| Duration of severe HFMD, 16–32 days | |||||
| Cost-saving | Cost-saving | 9,546 ~ 9,595 (-1% ~ 0%) | 29,331 ~ 29,483 (-1% ~ 0%) | 49,117 ~ 49,372 (-1% ~ 0%) | 68,903 ~ 69,260 (-1% ~ 0%) |
| Cost of mild adverse events after vaccination, ±50% | |||||
| Cost-saving | Cost-saving ~ 143 | 9,103 ~ 10,088 (-5% ~ 5%) | 28,991 ~ 29,976 (-2% ~ 2%) | 48,879 ~ 49,864 (-1% ~ 1%) | 68,768 ~ 69,753 (-1% ~ 1%) |
| Cost of serious adverse events after vaccination, ±50% | |||||
| Cost-saving | Cost-saving | 9,589 ~ 9,601 (0% ~ 0%) | 29,478 ~ 29,489 (0% ~ 0%) | 49,366 ~ 49,378 (0% ~ 0%) | 69,254 ~ 69,266 (0% ~ 0%) |
| Cost of outpatient visit due to EV71-associated HFMD, ±50% | |||||
| Cost-saving | Cost-saving ~ 2,216 | 7,030 ~ 12,160 (-27% ~ 27%) | 26,918 ~ 32,049 (-9% ~ 9%) | 46,806 ~ 51,937 (-5% ~ 5%) | 66,695 ~ 71,825 (-4% ~ 4%) |
| Cost of outpatient visit due to EV71-associated herpangina, ±50% | |||||
| Cost-saving | Cost-saving | 9,527 ~ 9,663 (-1% ~ 1%) | 29,415 ~ 29,552 (0% ~ 0%) | 49,303 ~ 49,440 (0% ~ 0%) | 69,192 ~ 69,328 (0% ~ 0%) |
| Cost of hospitalization due to EV71-associated HFMD, ±50% | |||||
| Cost-saving | Cost-saving ~ 3,159 | 6,087 ~ 13,104 (-37% ~ 37%) | 25,975 ~ 32,992 (-12% ~ 12%) | 45,863 ~ 52,880 (-7% ~ 7%) | 65,752 ~ 72,769 (-5% ~ 5%) |
| Cost of vaccine administration, ±50% | |||||
| Cost-saving | Cost-saving ~ 148 | 9,098 ~ 10,092 (-5% ~ 5%) | 28,986 ~ 29,981 (-2% ~ 2%) | 48,875 ~ 49,869 (-1% ~ 1%) | 68,763 ~ 69,757 (-1% ~ 1%) |
| Discount rate for both cost and DALYs, 0–10% | |||||
| Cost-saving | Cost-saving ~ 4,257 | 3,520 ~ 42,004 (-63% ~ 338%) | 11,411 ~ 117,500 (-61% ~ 299%) | 19,303 ~ 192,995 (-61% ~ 291%) | 27,195 ~ 268,491 (-61% ~ 288%) |
| Discount rate for cost only, 0–10% | |||||
| Cost-saving | Cost-saving ~ 1,121 | 8,871 ~ 11,065 (-8% ~ 15%) | 28,759 ~ 30,954 (-2% ~ 5%) | 48,647 ~ 50,842 (-1% ~ 3%) | 68,536 ~70,730 (-1% ~ 2%) |
The percentages in parentheses represent the changes of incremental cost-effectiveness ratios from base-case analyses. The GDP per capita for China in 2012 was approximately $6,300.
DALYs: disability adjusted life years; EV71: enterovirus 71; HFMD: hand, foot and mouth disease.
§The numbers in parentheses represent the incremental cost-effectiveness ratios in base-case analyses.
‡The parameters in parentheses simultaneously change over their own value ranges.