Economic evaluation of pneumococcal conjugate vaccination in The Gambia

Kim, Sun-Young; Lee, Gene; Goldie, Sue J

doi:10.1186/1471-2334-10-260

BMC Infectious Diseases

Table 1 Assumptions on epidemiology, natural history, and disability weights

From: Economic evaluation of pneumococcal conjugate vaccination in The Gambia

Parameters	Baseline estimates	Ranges^a	Distributions^b	Sources
Epidemiological parameters
Incidence of primary endpoint pneumonia (per 1000/person-year)^c
< 6 months	32	25-41^d	Not varied	[9]
6-11 months	49	42-56^d	Not varied	[9]
12-17 months	46	40-54^d	Not varied	[9]
18-23 months	42	36-50^d	Not varied	[9]
24-29 months	20	15-27^d	Not varied	[9]
30-59 months	5	3-7	Not varied	[9]
Incidence of non-primary endpoint pneumonia (per 1000 person-year)^c
< 6 months	165	144-190	Not varied	[9]
6-11 months	184	166-203	Not varied	[9]
12-17 months	255	229-278	Not varied	[9]
18-23 months	214	193-237	Not varied	[9]
24-29 months	155	135-181	Not varied	[9]
30-59 months	27	23-31	Not varied	[9]
Estimated incidence of pneumococcal meningitis (per 100,000-year)^c
< 2 months	12.1	9.7-14.5	Not varied	Estimated
2-11 months	5.2	4.2-6.2	Not varied	Estimated
12-59 months	0.5	0.4-0.6	Not varied	Estimated
Ratio of incidence of childhood meningitis to sepsis attributable to S. pneumoniae	2.2	1.0-3.4	Triangular	[5, 43]
Natural history
Case-fatality rates
Primary endpoint pneumonia	3.0%	2-4%	Triangular	[9]
Non-primary endpoint pneumonia	1.1%	0.8-1.4%	Triangular	[9]
Meningitis (age-specific)
< 1 months	27%	20-34%	Not varied	[41]
1-5 months	23%	17-29%	Not varied	[41]
6-11 months	48%	36-60%	Not varied	[41]
12-59 months	46%	35-58%	Not varied	[41]
Sepsis	35%	26-44%	Triangular	[42]
Proportion hospitalized
Primary endpoint pneumonia	53.0%	40.0-66.3%	Triangular	[9]
Non-primary endpoint pneumonia	19.3%	14.5-24.1%	Triangular	[9]
Meningitis	100%	70-100%	Uniform	Assumed
Sepsis	100%	70-100%	Uniform	Assumed
Proportion of major disabilities (among disabled due to meningitis)	50%	40-60%	Triangular	[64]
Vaccine characteristics
Vaccine coverage (3 doses)	90	82-100	Triangular	Assumed
Vaccine serotype coverage
PCV7 (4, 6B, 9V, 14, 18C, 19F, 23F)	46%	Not varied	Not varied	[47]
PCV9 (1, 4, 5, 6B, 9V, 14, 18C, 19F, 23F)	62%	Not varied	Not varied	[47]
PCV10 (1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F with non-typeable H. influenzae)	62%	Not varied	Not varied	[47]
PCV13 (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F)	73%	Not varied	Not varied	[47]
Vaccine efficacy against (all-cause) primary endpoint pneumonia
PCV7	26%	20-33%	Triangular	Estimated
PCV9 & 10	35%	26-44%	Triangular	[9]
PCV13	41%	31-51%	Triangular	Estimated
Vaccine efficacy against (all-cause) non-primary endpoint pneumonia
PCV7	-1.1%	-2.0 to 0%	Triangular	Estimated
PCV9 & 10	-1.5%	-2.0 to -1.0%	Triangular	[9]
PCV13	-1.8%	-2.5 to -2.0%	Triangular	Estimated
Vaccine efficacy against pneumococcal meningitis/sepsis
PCV7	16%	14-18%	Triangular	Estimated
PCV9 & 10	22%	19-25%	Triangular	[8]
PCV13	26%	22-30%	Triangular	Estimated
Disability weights
Meningitis (aged 0-14), episode	0.616	0.462-0.77	Triangular	[29]
Meningitis, recovered with long-term disability	0.555	0.416-0.694	Triangular	[29]
Pneumonia (aged 0-14), episode	0.28	0.21-0.35	Triangular	[29]
Sepsis, episode	0	Not varied	Not varied	[29]

^a This column shows the ranges of parameters that were varied during one-way sensitivity analyses.
^b This column shows the distributions assigned to the parameters that were varied during the probabilistic sensitivity analysis. Since data often did not contain enough information from which to estimate distribution parameters, triangular distributions were chosen for a majority of the parameters.
^c Annual incidence rates were converted to monthly transition probabilities within the model, assuming an exponential relationship between the cumulative incidence at different time (age) intervals and time (age).
^d 95% confidence interval.

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