Table 2.
Outcomes of a Model Assessing Clinical Impact and Cost-effectiveness of Measles-Mumps-Rubella (MMR) Vaccination During Pretravel Health Encounter (PHE)
| Imported Measles Cases | US-acquired Measles Cases |
Averted Measles Cases | Costs (US$) |
ICER (US$/ Measles Case Averted) | |
|---|---|---|---|---|---|
| Base case per 10M US travelers (Riskexposure, 237 exposures/10M travelers) | |||||
| No PHE | 22 | 66 | 14800000 | ||
| PHE | 15 | 35 | 38 | 190300000 | 4611000 |
| By destination | |||||
| North America per 45M travelers (Riskexposure, 19 exposures/10M travelers) | |||||
| No PHE | 8 | 24 | 5300000 | ||
| PHE | 5 | 13 | 14 | 821800000 | 59484000 |
| Europe per 12M travelers (Riskexposure, 434 exposures/10M travelers) | |||||
| No PHE | 50 | 145 | 32700000 | ||
| PHE | 34 | 77 | 84 | 238000000 | 2440000 |
| Africa per 1.2M travelers (Riskexposure, 681 exposures/10M travelers) | |||||
| No PHE | 8 | 23 | 5100000 | ||
| PHE | 5 | 12 | 14 | 24800000 | 1493000 |
| Asia per 10M travelers (Riskexposure, 975 exposures/10M travelers) | |||||
| No PHE | 95 | 278 | 62600000 | ||
| PHE | 64 | 147 | 162 | 222100000 | 991000 |
| By hot spot | |||||
| Philippines (2014) per 600000 travelers (Riskexposure, 1940 exposures/10M travelers) | |||||
| No PHE | 11 | 32 | 7300000 | ||
| PHE | 7 | 17 | 19 | 15000000 | 412000 |
| India (2011) per 800000 travelers (Riskexposure, 2490 exposures/10M travelers) | |||||
| No PHE | 19 | 56 | 12500000 | ||
| PHE | 13 | 29 | 33 | 21600000 | 283000 |
| Poland (2013) per 170000 travelers (Riskexposure, 3340 exposures/10M travelers) | |||||
| No encounter | 5 | 16 | 3600000 | ||
| Pretravel encounter | 4 | 8 | 9 | 5100000 | 167000 |
| Pakistan (2013) per 99000 travelers (Riskexposure, 6750 exposures/10M travelers) | |||||
| No encounter | 6 | 18 | 4200000 | ||
| Pretravel encounter | 4 | 10 | 10 | 4100000 | Cost-saving |
Abbreviations: ICER, incremental cost-effectiveness ratio; MMR, measles-mumps-rubella; PHE, pretravel health encounter.