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Table 1 Comparison of the two analyses using an Excel-based model: Rotavirus versus HPV [6, 15, 18, 19, 3855]

From: Comparative evaluation of the potential impact of rotavirus versus hpv vaccination in GAVI-eligible countries: A preliminary analysis focused on the relative disease burden

Main features/Assumptions Rotavirus HPV
Study design overview   
Country/Region 72 GAVI-eligible countries Same
Study type Cost-effectiveness analysis Same
Perspective (Limited) societal perspective Same
Currency 2005 international dollars (I$) Same
Base year for discounting 2009 Same
Year of intervention 2010 Same
Primary outcome measure ICER (I$/DALY averted) Same
Discount rate (base-case) Health outcome: 3%, Cost: 3% Same
Model type and structure   
Model type Static cohort model (implicitly based on a decision tree) Same
Model outcomes Costs
Cases of rotavirus-associated deaths, hospitalizations, and outpatient visits
Life years saved
DALYs averted
Costs
Cases of cervical cancer and cervical cancer deaths
Life years saved
DALYs averted
Time horizon (span) 5 years (ages 0-4) Lifetime (ages 9-99)
Software for programming Microsoft Excel and VBA Same
Assumptions on intervention and vaccine efficacy  
Vaccine type Rotarix® or Rotateq®
(non-distinguished)
Gardasil® or Cervarix®
(non-distinguished)
Strategies Routine versus no vaccination Same
Target population Infants 9-year-old girls
Vaccination schedule 2,4,and 6 months of age The second and third doses administered 1 and 6 months after the first dose
Coverage (base-case) 70% Same
Vaccine efficacy (serotype-specific) G1P[8]: 87%
G3P[8]: 90%
G4P[8]: 93%
G9P[8]: 84%
G2P[4], other combination:71%
100% against cervical cancer caused by HPV 16/18
Vaccine efficacy adjusted for serotype distribution Yes Yes
Assumptions on natural history   
Serotype distribution Country-specific Same
Duration of vaccine immunity 5 years (ages 0-4) Lifetime (ages 9-99)
Waning of vaccine-acquired immunity No No
Natural immunity considered No No
Herd immunity considered No No
Assumptions on resource use   
Range of costs included Direct medical costs (composite program costs and medical treatment costs) Same
Working definition and description of composite program costs A composite vaccination program cost was defined to be a total cost per vaccinated individual for delivering a full course of vaccines, and was assumed to include the following cost items: vaccine purchase, vaccine wastage, freight and insurance, administrative cost, immunization support (including cold chain, training, and operational costs), and other programmatic costs (including surveillance and monitoring and social mobilization).
For a composite cost of I$10 and I$25, vaccine purchase cost was US$4.5 (3 doses at US$.50 each) and US$15 (3 doses at US$5 each), respectively.
Same
Levels of composite costs used in a comparative simulation I$10 and I$25 Same
Medical utilization for treatment 1) Rotavirus gastroenteritis requiring outpatient visit: one time outpatient clinic visit
2) Rotavirus gastroenteritis requiring hospitalization: one time outpatient visit plus a 3-day admission
3) Rotavirus gastroenteritis leading to deaths: one time outpatient visit plus a 3-day admission
Stage-specific treatment costs assume diagnostic workup, inpatient and outpatient visits, follow-up [6, 15]
Access to care 100% for the base-case
(varied in a sensitivity analysis)
Same
Sources of key data   
Population prospect UN Population Prospect, The 2006 Revision [38] Same
Life expectancy WHO life tables (year 2006) [39] Same
Incidence (rotavirus-associated deaths or cervical cancer) WHO estimates [40]
Published literature [20, 21]
1) GLOBOCAN 2002 [41]
2) Cancer incidence in five continents (CI5C), vol. I-VIII [42]
3) Cancer in Africa [43]
Treatment cost data WHO-CHOICE [44] WHO-CHOICE [44]
Published literature [6, 15, 18, 19]
Serotype distribution Published literature [4554] Published literature [28]
Disability weights Global Burden of Diseases 1990 [55] Same
  1. ICER = incremental cost-effectiveness ratio, DALY = disability-adjusted life year.