Table 3.

Health-Economic Outcomes for Different IPV oSIA Options in Northwest Nigeria

					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

^a.Including treatment costs savings associated with prevented polio cases.

^b.Comparator uses same IPV take rate for IPV used in SIAs prior to OPV2 cessation and in routine immunization as IPV oSIA strategy assumes.

^c.Assumes no impact on cases prevented.

^d.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.