Economic evaluation of pneumococcal conjugate vaccination in The Gambia

BMC Infectious Diseases

Table 2 Assumptions on resource utilization

Parameters^a	Baseline estimates	Ranges^b	Distributions^c	Sources
Vaccination costs
Vaccine price (per dose), $	3.5	0-10	Triangular	[18]
Vaccine wastage rate,%	10	0-20	Triangular	Assumed
Program costs for vaccine delivery^d (per dose), $	0.34	0-0.68	Triangular	Estimated
Disease treatment costs, $
Medical visits
Cost per hospital bedday	5.01	2.51-7.52	Triangular	[49]
Cost per outpatient visit	1.31	0.66-1.97	Triangular	[49]
Diagnostics
Pneumonia (inpatient)	4.18	3.14-5.23	Triangular	[50]
Meningitis	1.19	0.89-1.49	Triangular	[50]
Sepsis	4.10	3.08-5.13	Triangular	[50]
Medication
Pneumonia (inpatient)	Age-specific	1.19-3.25	Not varied	Estimated
Pneumonia (outpatient)	Age-specific	0.04-0.08	Not varied	Estimated
Meningitis	Age-specific	4.26-14.62	Not varied	Estimated
Sepsis	Age-specific	6.13-16.68	Not varied	Estimated
Direct non-medical costs, $
Transportation costs (per travel)	0.41	0.31-0.51	Triangular	[56]
Caregiver's time costs^e (per disease event)
Pneumonia, inpatient^f	2.16	1.08-3.24	Triangular	Estimated
Pneumonia, outpatient^g	0.21	0.11-0.32	Triangular	Estimated
Meningitis, inpatient^f	8.64	4.32-12.96	Triangular	Estimated
Sepsis, inpatient^f	8.64	4.32-12.96	Triangular	Estimated
Wage^h (her hour)	0.09	0.05-0.14	Triangular	Estimated

^a All cost estimates are expressed in 2005 US dollars.
^b The ranges of parameters are for univariate sensitivity analyses and are chosen to be as inclusive as possible based on the literature.
^c Because most data sources for costs did not provide enough information, we assumed triangular forms for all cost parameters.
^d Delivery costs included all incremental non-recurrent (capital) and recurrent (operational) program costs incurred under the current Gambian immunization system, beyond the purchase cost of the vaccines themselves and vaccine wastage.
^e Caregiver's time costs were calculated based on the human capital approach.
^f Caregiver's time costs for inpatient care were calculated using the following formula: the estimated average hourly wage ($0.09/hour) × 8 hours/day × average length of stay for each disease event (3 days for pneumonia and 12 days for meningitis and sepsis).
^g Caregiver's time costs for outpatient care for pneumonia were calculated using the following formula: the estimated average hourly wage ($0.09/hour) × average time for travel/waiting/treatment at public health facilities in The Gambia (2.3 hours).
^h Average hourly wage for The Gambia was estimated based on data from multiple global sources (e.g., World Development Indicators by the World Bank, The CIA Fact Book, and the International Confederation of Free Trade Unions) taking into account the major industries, employment rate by gender, and size of the workforce in The Gambia.

ISSN: 1471-2334