Skip to main content

Table 4 Scenario analyses (expected value analysis; average costs and QALYs DW gained per individual 12-year-old over their whole lives

From: Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program

 

Each intervention compared to no HPV vaccination

Incremental comparisons

Interventions

Output

Intervention 1G:Replicating the GIRLS-ONLYNZ program in 2011

Intervention 2G:Intensive GIRLS-ONLYprogram, school-based

Intervention 1G + B:Adding BOYSto the GIRLSNZ program in 2011

Intervention 2G + B:Adding BOYSto the intensive GIRLSprogram, school-based

[A] Intervention 2G c.f. Intervention 1G

[B] Intervention 1G + B c.f. Intervention1G

[D] Intervention 2G + B c.f. Intervention 2G

From Table 3, expected value only analysis

Net cost (NZ$)

$81

$129

$235

$372

$47

$154

$244

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

$18,100

$21,900

$40,000

$53,700

$34,000

$111,000

$234,000

Vaccine price halved (NZ$56)

Net cost (NZ$)

$41

$68

$154

$248

$27

$112

$180

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

$9,200

$11,600

$26,200

$35,800

$19,000

$81,300

$173,000

Very low vaccine price ($7.46) = GAVI price ~ US$5)

Net cost (NZ$)

$7

$16

$84

$142

$9

$76

$126

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

$1,600

$2,800

$14,300

$20,500

$6,500

$55,300

$121,000

Highly hypothetical vaccine price $NZ 1

Net cost (NZ$)

$3

$10

$75

$129

$7

$72

$119

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

$700

$1,700

$12,800

$18,600

$4,900

$52,200

$115,000

Plausibly lower vaccine administration costs (NZ$19)

Net cost (NZ$)

$-4

$14

$61

$138

$18

$65

$124

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

Dominant

$2,400

$10,400

$20,000

$12,800

$47,000

$119,000

Hypothetical vaccine price NZ$1 + lower vaccine administration costs (NZ$19)

Net cost (NZ$)

$-80

$-103

$-99

$-110

$-22

$-18

$-7

QALYsDW gained

0.0046

0.0059

0.0058

0.0069

0.0013

0.0012

0.0010

ICER

Dominant

Dominant

Dominant

Dominant

Dominant

Dominant

Dominant

GAVI vaccine price + lower vaccine administration costs (NZ$19)

Net cost (NZ$)

$-77

$-99

$-90

$-94

$-22

$-12

$5

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

Dominant

Dominant

Dominant

Dominant

Dominant

Dominant

$5,000

Discount rate 0%

Net cost (NZ$)

$-28

$-23

$80

$183

$5

$108

$205

QALYsDW gained

0.0135

0.0186

0.0190

0.0233

0.0051

0.0055

0.0047

ICER

Dominant

Dominant

$4,200

$7,900

$1,000

$19,400

$43,900

Cost and QALYsDW discount rate 6% (double baseline)

Net cost (NZ$)

$123

$186

$293

$443

$63

$170

$257

QALYsDW gained

0.0025

0.0031

0.0030

0.0035

0.0006

0.0006

0.0004

ICER

$50,100

$59,900

$96,500

$127,000

$97,000

$294,000

$695,000

Excluding unrelated health system costs †

Net cost (NZ$)

$73

$117

$222

$356

$44

$150

$240

QALYsDW gained

0.0045

0.0059

0.0059

0.0069

0.0014

0.0014

0.0010

ICER

$16,200

$19,800

$37,900

$51,500

$31,500

$109,000

$231,000

Excluding disease DWs (i.e., no morbidity impacts of HPV-related disease) ^

Net cost (NZ$)

$81

$129

$235

$372

$47

$154

$244

QALYsDW gained

0.0011

0.0016

0.0017

0.0022

0.0006

0.0007

0.0006

ICER

$76,500

$79,800

$137,000

$166,000

$86,200

$233,000

$383,000

Excluding both background morbidity and disease DWs (i.e., life years gained analysis, ignoring morbidity)

Net cost (NZ$)

$81

$129

$235

$372

$47

$154

$244

QALYsDW gained

0.0015

0.0023

0.0024

0.0031

0.0008

0.0009

0.0009

ICER

$53,100

$56,300

$96,700

$119,000

$62,700

$171,000

$284,000

Excluding herd immunity benefits related to anal and oropharyngeal cancers for males when only females vaccinated: 1G (i.e., considering underestimation of benefits to MSM in 1G + B)

Net cost (NZ$)

 

$144

 

QALYsDW gained

0.0018

ICER

$80,000

  1. † That is ignoring the health costs from diseases other than those specifically modeled, which increase net costs as living longer is associated with costs from (other) future disease and disability.
  2. ^ That is the DWs for cancers, CIN and anogenital warts states are all set to zero – but the background morbidity is retained. The health gain realized from HPV vaccination is therefore only from preventing premature death from cancer. NOTE: all items in bolded font are cost-saving.
Back to article page

BMC Infectious Diseases

ISSN: 1471-2334

Contact us