Table 3.
Incremental Cost-Effectiveness
Ratio |
Incremental Net Benefits | ||||||
---|---|---|---|---|---|---|---|
IPV oSIA Strategy | Comparator | Full IPV Doses Needed | Incremental Costsa ($) | Expected Polio Cases Prevented (During 2017) | $/Polio Case Prevented | $/DALY Averted | |
IPV added during oSIA1 | No IPV | 1.4 M | 2.6 M | 0.6 | 4.1 M | 330,000 | −2.6 M |
IPV added during oSIA2 | No IPVb | ||||||
Baseline | 14 M | 26 M | 0.4 | 59 M | 4.8 M | −26 M | |
0% discount rate | 14 M | 26 M | 0.4 | 59 M | 0.79 M | −26 M | |
10% discount rate | 14 M | 26 M | 0.4 | 59 M | 12.8 M | −26 M | |
Lower end IPV take rate (30%) | 14 M | 26 M | 0.2 | 110 M | 8.9 M | −26 M | |
Upper end IPV take rate (95%) | 14 M | 26 M | 0.6 | 43 M | 3.5 M | −26 M | |
Fractional IPV dosesc | 3.4 M | 8.9 M | 0.4 | 20 M | 1.6 M | −8.9 M | |
Most optimisticd | 1.4 M | 2.3 M | 0.6 | 3.5 M | 140,000 | −2.2 M | |
IPV added during oSIA5 | No IPV | 14 M | 26 M | 0.0 | 4.0 B | 330 M | −26 M |
IPV added during all oSIAs | No IPV | 58 M | 110 M | 1.1 | 98 M | 7.9 M | −110 M |
IPV 5–9 during oSIA2 | No IPV | 12 M | 26 M | 0.2 | 160 M | 12.9 M | −26 M |
No IPV but expand oSIA2 through age 9 | 12 M | 19 M | −0.0 | Dominated | Dominated | −19 M | |
IPV 5–14 during oSIA2 | No IPV | 23 M | 48 M | 0.2 | 250 M | 20 M | −48 M |
No IPV but expand oSIA2 through age 14 | 23 M | 35 M | −0.0 | Dominated | Dominated | −35 M | |
IPV in general during oSIA1 | No IPV | 13 M | 24 M | 0.9 | 26 M | 2.0 M | −24 M |
IPV-only in general during oSIA2 | No IPV | 13 M | 20 M | −1.5 | Dominated | Dominated | −19 M |
Note: IPV = inactivated poliovirus vaccine; oSIA = outbreak response supplemental immunization activity; DALY = disability-adjusted life-year; OPV = oral poliovirus vaccine; OPV2 = serotype 2-containing OPV
Including treatment costs savings associated with prevented polio cases.
Comparator uses same IPV take rate for IPV used in SIAs prior to OPV2 cessation and in routine immunization as IPV oSIA strategy assumes.
Assumes no impact on cases prevented.
Assumes 0% discount rate, 95% IPV take rate, fractional IPV doses with no wastage, IPV price of $0.75 per full dose, and $0.30 incremental administration costs for IPV co-administered with OPV compared to OPV-only.