Cost-effectiveness analysis of a universal mass vaccination program with a PHiD-CV 2+1 schedule in Malaysia

Table 6 Estimated economic impacts of no vaccination, PCV13 2+1 and PHiD-CV 2+1 vaccination programs

	No vaccination	PCV13	PHiD-CV	PHiD-CV versus no vaccination	PHiD-CV versus PCV13
Undiscounted costs (USD)
Vaccination costs	0	52,119,711	52,119,681	+52,119,681	–30
Acute episode costs
IPD	2945,307	1,553,212	1,602,129	–1,343,178	+48,917
Meningitis	1,753,066	914,936	944,383	–808,683	+29,447
Bacteremia	1,192,241	638,276	657,746	–534,495	+19,470
All-cause pneumonia	106,306,148	99,249,563	99,249,006	–7,057,142	–557
AOM	108,394,044	100,136,093	94,366,242	–14,027,802	–5,769,851
Total direct costs	217,645,499	253,058,579	247,337,058	+29,691,559	–5,721,521
QALYs	4,590,144	4,591,267	4,591,392	+1,248	+125
ICER				23,792	PHiD-CV dominant
Discounted costs (USD)^a
Total direct costs	190,226,159	226,321,520	221,112,241	+30,886,082	–5,209,279
QALYs	3,979,331	3,980,299	3,980,415	+1084	+116
ICER	–	–	–	28,497 (cost-effective)	PHiD-CV dominant

Costs are in 2014 USD
AOM acute otitis media, ICER incremental cost-effectiveness ratio, IPD invasive pneumococcal disease, PCV13 13-valent pneumococcal conjugate vaccine, PHiD-CV pneumococcal polysaccharide and NTHi protein D conjugate vaccine, QALY quality-adjusted life-year, USD United States dollars
In Malaysia over 10 years for a birth cohort of 508,774
^aDiscounted at 3% per annum [23]

ISSN: 1478-7547