Table 1 Incidence rate reduction, incremental costs, DALYs averted, and incremental cost-effectiveness ratios for different vaccination programme scenarios compared to a counterfactual scenario without vaccination.

From: Cost-effectiveness of routine adolescent vaccination with an M72/AS01E-like tuberculosis vaccine in South Africa and India

Scenario description

Incidence rate reduction in 2050 (%)

Incremental health system cost ($USD million)

DALYs averted

Cost per DALY averted—health system perspective ($USD)

Incremental health system and patient cost ($USD million)

Cost per DALY averted—societal perspective ($USD)

South Africa

Pre- and post-infection efficacy

10-year-olds, 80% coverage

11.3 (7.9, 14.3)

22.7 (−24.3, 86.9)

555,707 (424,020, 7,547,352)

41.6 (−40.6, 163.5)

9.8 (−40.8, 73.4)

17.6 (−68.0, 137.5)

15-year-olds, 80% coverage

14.1 (9.2, 18.4)

14.3 (−42.3, 85.3)

665,283 (495,032, 966,186)

20.6 (−56.2, 143.1)

−4.8 (−64.2, 65.0)

Dominant −7.2 (−86, 109.0)

18-year-olds, 50% coverage

9.5 (6.3, 12.4)

11.0 (−26.3, 58.9)

441,175 (332,273, 628,197)

24.3 (−57.3, 140.8)

−1.6 (−44.2, 46.5)

Dominant −3.6 (−91.2, 113.8)

Post-infection efficacy only

10-year-olds, 80% coverage

0.9 (0.6, 1.3)

70.6 (30.8, 133.7)

55,141 (41,465, 79,327)

1241.0 (519.9, 2555.0)

68.9 (29.5, 132.4)

1217.1 (502.5, 2526.1)

15-year-olds, 80% coverage

2.1 (1.5, 3.0)

64.3 (23.9, 129.6)

127,054 (91,551, 186,339)

497.1 (172.2, 1133.8)

61.1 (20.5, 125.6)

474.2 (144.3, 1102.4)

18-year-olds, 50% coverage

2.0 (1.4, 2.7)

39.0 (11.3, 81.4)

119,851 (89,246, 170,901)

320.9 (86.4, 743.3)

35.3 (7.8, 77.6)

290.1 (58.3, 723.1)

India

Pre- and post-infection efficacy

10-year-olds, 80% coverage

15.2 (12.8, 18.7)

232.5 (−714.6, 1646.4)

5,936,801 (4,284,243, 8,609,081)

38.1 (−106.4, 312.9)

−174.6 (−1528.9, 1392.0)

Dominant −28.1 (−232.9, 255.9)

15-year-olds, 80% coverage

21.8 (18.3, 26.4)

−694.1 (−1891.0, 853.5)

9,905,887 (7,073,810, 14,271,184)

Dominant −70.4 (−172.5, 93.74)

−1349.4 (−3580.0, 39.1)

Dominant −134.6 (−330.4, 45.1)

18-year-olds, 50% coverage

14.5 (12.2, −17.6)

−486.9 (−1255.7, 438.3)

6,416,849 (4,634,098, 9,148,222)

Dominant −73.5 (−176.3, 72.8)

−885.6 (−2180.9, 123.3)

Dominant −135.1 (−324.4, 19.6)

Post-infection efficacy only

10-year-olds, 80% coverage

0.7 (0.5, 0.9)

1526.6 (714.7, 2885.6)

404,065 (252,210, 667,108)

3736.9 (1493.8, 8252.1)

1506.4 (694.9, 2860.6)

3 690.8 (1415.2, 8191.6)

15-year-olds, 80% coverage

1.7 (1.2, 2.4)

1353.9 (510.7, 2763.9)

894,399 (542,021, 1,471,362)

1513.1 (499.9, 3733.2)

1290.4 (412.7, 2687.5)

1441.0 (391.4, 3676.0)

18-year-olds, 50% coverage

1.7 (1.3, 2.3)

813.3 (225.0, 1651.1)

896,801 (565,477, 1,429,151)

917.0 (231.3, 2269.3)

736.8 (142.4, 1573.8)

822.4 (143.8, 2172.5)

  1. Figures represent median, and range (incidence rate reduction) or 5th and 95th percentile values (all others) from 1000 calibrated model runs. Incidence rate reduction is the percentage reduction in tuberculosis incidence in 2050 in scenarios with vaccination compared to the counterfactual scenario without vaccination. Costs estimated from a health service perspective. All costs and DALYs discounted at 3%/year. Cost effectiveness thresholds—South Africa: $2480/DALY averted, India: $264/DALY averted.
  2. DALY disability-adjusted life year, USD United States Dollars.
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