Volume 20, Number 1—January 2014
Research
Dynamic Modeling of Cost-effectiveness of Rotavirus Vaccination, Kazakhstan
Table 4
Estimated projected costs and avoided health outcomes of rotavirus vaccination program in Kazakhstan, 2012–2031
Outcome |
No vaccination |
Base case, 90% vaccine coverage, 1-y vaccination protection |
Scenario A, 80% vaccine coverage, 1-y vaccination protection |
Scenario B, 100% vaccine coverage, 1-y vaccination protection |
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---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean |
Low |
High |
Mean |
Low |
High |
Mean |
Low |
High |
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Avoided outcomes, undiscounted | ||||||||||||||
Fatal cases | 1,310 | 880 | 776 | 1,004 | 777 | 681 | 890 | 985 | 876 | 1 114 | ||||
In-hospital care | 77,205 | 51,891 | 46,094 | 57,971 | 45,802 | 40,436 | 51,447 | 58,086 | 52,038 | 64,396 | ||||
Out-patient visits | 550,896 | 370,268 | 211,825 | 541,919 | 326,820 | 185,825 | 480,935 | 414,473 | 239,145 | 601,983 | ||||
Home care episodes | 2,675,456 | 1,344,747 | 640,836 | 2,112,400 | 1,163,780 | 552,160 | 1,835,487 | 1,544,096 | 740,039 | 2,412,843 | ||||
Life years gained |
54,784 |
48,304 |
62,442 |
48,356 |
42,375 |
55,416 |
61,325 |
54,534 |
69,363 |
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Vaccination | 530.7 | 530.7 | 530.7 | 471.9 | 471.9 | 471.9 | 589.6 | 589.6 | 589.6 | |||||
In-hospital care | −25.7 | −18.9 | −16.8 | −21.2 | −16.7 | −14.7 | −18.7 | −21.2 | −18.9 | −23.5 | ||||
Out-hospital care | −16.3 | −12.0 | −6.9 | −17.6 | −10.6 | −6.0 | −15.6 | −13.4 | −7.8 | −19.5 | ||||
Homecare | −8.5 | −4.7 | −2.2 | −7.4 | −4.1 | −1.9 | −6.4 | −5.4 | −2.6 | −8.4 | ||||
Indirect costs | −179.4 | −122.3 | −88.4 | −159.7 | −107.4 | −77.4 | −140.9 | −137.7 | −100.3 | −178.9 | ||||
Total net costs |
229.9 |
372.8 |
416.4 |
325.0 |
333.1 |
371.8 |
290.2 |
411.9 |
460.1 |
359.3 |
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Incremental cost-effectiveness ratios, societal perspective |
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Discounted 3% |
NA |
18,044 |
22,779 |
13,854 |
18,280 |
27,991 |
13,955 |
17,775 |
22,250 |
13,768 |
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Incremental cost-effectiveness ratios, health care perspective |
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Discounted 3% |
NA |
23,892 |
27,573 |
20,557 |
24,102 |
23,210 |
20,620 |
23,658 |
27,061 |
20,526 |
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Threshold prices, 3% discounting |
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Medical break-even price† | NA | $2.78 | $2.01 | $3.62 | $2.78 | $1.96 | $3.60 | $2.83 | $2.05 | $3.65 |
*Negative values indicate prevented or avoided costs. NA, not applicable.
†The price per vaccine dose at which the vaccinations costs are offset by cost saving generated from lower morbidity and mortality rates.