Health and economic consequences of different options for timing the coordinated global cessation of the three oral poliovirus vaccine serotypes

Table 3 Incremental economic outcomes for different OPV cessation timing options compared to the current timing plan based on vaccination costs and expected paralytic polio cases between 2015 and 2019

Alternative	Incremental cost-effectiveness ratio^a				Incremental net benefits ($)
Alternative	LOW	LMI	UMI	HIGH	LOW	LMI	UMI	HIGH	All
OPV23 cessation in 2017	CLS	CLS	CLS	CLS	0.3	3.0	2.7	1.3	7.3
OPV123 cessation in 2018	CLS	CLS	CLS	1.9	300	660	190	−8.6	1,100
OPV123 cessation in 2019	Dominated	Dominated	Dominated	Dominated	−0.3	−2.6	−1.6	0	−4.6
OPV123 cessation in 2019 with tOPV-only from 2017	Dominated	Dominated	Dominated	Dominated	−0.3	−2.5	−1.6	0	−4.5
OPV123 cessation in 2019 with IPV added from 2018	CSLC	CSLC	CSLC	Dominated	110	370	380	0	860

Abbreviations: HIGH, high-income; IPV, inactivated poliovirus vaccine; LMI, lower middle-income; LOW, low-income; OPV, oral poliovirus vaccine; OPV(##) cessation, globally-coordinated cessation of OPV containing the serotype(s) indicated by ##; UMI, upper middle-income; $, 2013 United States dollar
^aNumbers represent millions of $ per disability-adjusted life-year averted; Letters are: CLS, cost and life-saving (i.e., negative incremental costs and positive cases prevented); CSLC cost-saving but life-costing (i.e., positive incremental costs and negative cases prevented); Dominated, positive incremental costs and negative cases prevented