Figure 2 shows the effect of infection risk (including both symptomatic and asymptomatic cases), vaccination price, and vaccine efficacy on the cost-effectiveness of vaccinating children ≤ 1 year of age against dengue infection.
Vaccinating even proved to be cost-effective with a vaccination price point of $800 when vaccine efficacy was 95% and infection risk was 15%.
Moreover, despite recent reports that Hong Kong residents would be sensitive to vaccination pricing when considering whether to vaccinate [11], [12], only 2.5% of our respondents cited high vaccine cost as the reason for rejecting vaccination.
Vaccination remained cost-effective (4,289 > ICER < 12,868) through vaccination costs of $200, and remained cost-effective at vaccination price points of $400 if the vaccine efficacy was at least 75% and infection incidence was ≥ 9%.
At this lower asymptomatic rate the vaccine remained cost-effective up to a $300 vaccination price.
In the HIV+ subpopulation analysis, the price range between highly cost-effective and cost-effective vaccination price is between ZAR 450 and 950 per vaccine dose respectively (Fig. 4b).
In fact, with a vaccination price point of $1.50 for the vaccination series, administration of the vaccine was actually cost saving.
to the New Zealand situation – whilst important – does not appear to be enough to alter the general conclusion that vaccinating boys in New Zealand is not cost-effective (in the absence of large vaccination price reductions).
In the overall population analysis, with 50%% increase in the vaccination price (Fig. 4a), results show that HPV vaccination is still cost-effective.
Vaccinating was highly cost-effective (ICER < 4,289) for all scenarios up to a $60 vaccination price point, and dominated (i.e., was less costly and more effective than) not vaccinating in most scenarios at efficacies of at least 75% when the total cost of the 3-dose vaccine was $1.50 or less.
