Table 1.
Summary of 11 economic models reviewed.
| Article | Year | 2001 | 2006 | 2006 | 2009 | 2011 | 2011 | 2011 | 2014 | 2016 | 2016a | 2016b |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Author | Bos | Amirfar | Ono | Long 1 | Long 2 | Hontelez | Leelahavarong | Stover | Harmon | Moodley 1 | Moodley 2 | |
| Journal, Ref | Pharmacoecon. | JAIDS | Jpn J Infectious Dis | Vaccine | Vaccine | Vaccine | BMC Public Health | PLOS one | PLOS one | Medicine | BMC Public Health | |
| Study Population | Region | Sub-Saharan Africa | South Africa | Thailand | United States | United States | Hlabisa sub-district in South Africa | Thailand | 24 low and middle income countries | 24 low and middle income countries | South Africa | South Africa |
| Targeted group | Infants | 15-year old females | 10-year old children | ages 15-49 years, gen. pop., MSM and IDU | ages 15-64 years, gen. pop., MSM and IDU | ages 15-49 years | ages 18-30 years, gen. pop., FSW, MSM, IDU and military | ages 15-49 years, gen. pop., FSW, MSM and IDU | 15-49 years | 9-year old children | 10-year old children | |
| HIV Epidemiology | 35% lifetime chance of infection | 8% HIV prevalence, 2.5-15% HIV incidence | 1.5% HIV prevalence, Gender-specific Thai HIV incidence, not presented | HIV prevalence 0.14%-0.29% gen. pop,11-19% MSM, 14-17% IDU | HIV prevalence 0.1%-0.22% gen. pop,12.6-18.8% MSM, 12.9-17.3% IDU | HIV prevalence 30% | HIV incidence 0.1% gen. pop, 2.2% FSW, 5.55 MSM, 3.4% IDU | Prevalence 0.1 - 18.8, country specific | Prevalence 0.1 - 18.8, country specific | HIV prevalence 9.9% men, 14.4% women-HIV incidence 1.21% men, 2.28% women- | Age specific HIV prevalence | |
|
| ||||||||||||
| Vaccine | Vaccine Efficacy | 60% | 10-50% | 30% | 75% | 31% over 3 years | 31% over 3 years | 50% | 60-80% | 70% | 50% | 50% |
| Durability of Protection | Lifetime | Waning | Lifetime | Lifetime | Waning, booster every 3-5 years | Waning, booster every 3-5 years | Lifetime or booster every 5-10 years | Booster every 3-10 years | Booster every 5 years | 10 years, annual boosters | 10 years, annual boosters | |
| Price per series | $5 | $20 | $1.54 | $1,000 | $500 | $75 | $100 | $20, $55 | $20, $55 | $60 | $60 | |
|
| ||||||||||||
| Model Structure | Structure | Decision tree | Markov | Markov | Compartmental | Compartmental | Micro-simulation | Semi-Markov | Compartmental | Compartmental | Semi-Markov | Semi-Markov |
| Outcome | DALY | LY | LY and DALY | QALY | QALY | LY ∼ DALY | QALY | QALY | QALY | QALY | YPG | |
| Perspective | Societal | Payer* | Medical service decision makers | Societal* | Societal | Societal* | Government Perspective | Health System* | Health System* | Health care service provider | Health care service provider | |
| Discounting, 3% | Costs & Outcomes | Costs only | Costs & Outcomes | Costs & Outcomes | Costs & Outcomes | Costs & Outcomes | Costs & Outcomes | Costs only | Costs only | Costs & Outcomes | Costs & Outcomes | |
| Time Horizon | 55 years | 10 years | Lifetime | 20 years | 10 years | 10 years | 99 years | 25 years | 43 years | Lifetime | Lifetime | |
| Transmission | Static | Static | Static | Dynamic | Dynamic | Dynamic | Static | Dynamic | Dynamic | Static | Static | |
|
| ||||||||||||
| Results | ICER | $3.4/DALY | Dominant, cost-offsets | $99/DALY | $15,000/QALY | $91,000 per QALY | Dominant, cost-saving | $9,5000 per QALY | $1,160 - $11,000 per QALY | $1,000 - $10,000/QALY | $43 per QALY | $5/LYG |
| Threshold for Cost-Effectiveness | $100/DALY | not defined | $21,000/DALY | $50,000/QALY | $50,000/QALY | $30,420/DALY | $6,000/QALY | not defined | $4,671, $28,400/QALY | $7,508/QALY | $7,508/QALY | |
| Interpretation of Cost-Effectiveness | Cost-Effective | Cost-Saving | Cost-Effective | Cost-Effective, Cost-saving if target high-risk | Not cost-effective, Cost-saving if target high-risk | Cost-effective if price <$100 | Not cost-effective, Cost-Effective if 70% efficacy | No interpretation | Highly cost-effective | Highly cost-effective | Highly cost-effective | |
Notes: The parameters and ICERs represent the base case or average values in each analysis and do not reflect ranges evaluated in sensitivity analyses.
*
These studies did not explicitly state their economic perspective, and the perspective listed here was deduced by review authors based on context. Two values are listed for several Harmon parameters to reflect the separate low-income country (LIC) and middle-income country (MIC) analyses. Blue shading: 2011 study is an update to the 2009 model by same author. Pale grey shading: Stover and Harmon studies both used the Goals model with Spectrum software, so parameters are similar. Dark grey shading: two models in one calendar year by same first author with similar parameters.