According to the base case results of the manufacturer, EVE plus EXE compared to EXE alone generated incremental costs of £27,086, as well as 0.84 incremental QALYs (ICER: £32,417/QALY).
Even though a direct comparison of the base case results of the two analyses is not possible, the reported sensitivity analysis applying the maximum vaccine protection duration (100 years) for the cohort aged 65 in the Van Hoek et al. study (£5,660/QALY), produced almost identical results to our study (£5,583/QALY) when we set the vaccine price and population size equal.
The impact on the base case results of matching just with the Pscore rather than the individual covariates (GenMatch), of limiting DrotAA to within 24 hours, of increasing the drug cost, and of changing the duration of excess mortality and HRQOL decrement are shown in Table 6.
Thus, using the base case results of $1.91 per fever from Table 1 and Table 2, the annual average cost to households of fevers in one child is estimated to include $4.62 in direct cash expenses and 15.44 days of caretaker time, for a total of $20.06 annually.
The results of the PSA correlated the base case results for each of the patient population groups.
In the base case result (i.e. vaccination of girls only, 85% vaccination rate) an ICER of 3,581 €/QALY is estimated when all HPV-related diseases are taken into account.
The top line shows the base case result and represents the scenario of aspirin resulting in a 50% reduction in 5 year cumulative EAC incidence.
These points included: the decision problem; regional treatment patterns; cost inputs; use of local data; sensitivity analysis parameters; base case results; and results of probabilistic and sensitivity analyses.
Despite these differences, as well as the use of several input parameters which relied on secondary data, considering a cohort aged 65, the base case resulted in ICERs of similar magnitude to our study, with values below £10,000 per QALY gained from a NHS perspective.
The results of the probabilistic analysis, which varied the event rates, costs, and utilities, support the deterministic base case results with a ratio of $9,9429595% CI $9,764 $10,120) per QALY, with 93% probability of a ratio below $20,000 per QALY gained.
