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Weycker et al. [ 11] used effectiveness assumptions similar to those used in Smith et al. [ 9] for PPSV23, and they used pediatric data for pneumonia effectiveness assumptions for adult use of PCV13.
See table 6 for an overview of sensitivity analyses for the discount rates of 0% and 5% and effectiveness assumptions of 3 years and 20 years.
These results differ significantly from previous analyses, due, in part, to our PPSV23 NBPP effectiveness assumptions, which were obtained through a Delphi panel process.
We also performed sensitivity analyses for the discount rates of 0% and 5% and effectiveness assumptions of 3 years and 20 years.
40 For this reason we modified our policy effectiveness assumptions for laws on a smoke-free environment, bans on marketing, and warnings on packaging to account for low awareness of the harms of tobacco in the adult population of China.
Results from both models were sensitive to effectiveness assumptions for each vaccine, and both models included the assumption that PPSV23 was ineffective in the prevention of NBPP [ 10, 11].
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The overall conclusion of the studies based on this equal effectiveness assumption was that vaccination of the elderly is highly cost-effective, or indeed in many instances even cost saving.
Indeed, the effectiveness assumption does not appear to be founded on clear evidence.
If an excretor receives PAVDs, we randomly determine whether the infection clears based on the effectiveness assumption (i.e., 40%% or 90%%) and assume this occurs within a month of the start of PAVD treatment.
We have previously reported the basis of the validity of our transmission model on which our cost-effectiveness assumptions are based [ 4].
The results were robust in sensitivity analyses (Table 5) with cost and cost-effectiveness assumptions most sensitive to valuation of staff time.
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