Value in Health Regional Issues Cost-Effectiveness Analysis of Pneumococcal Vaccination with the Pneumococcal Polysaccharide NTHi Protein D Conjugate Vaccine in the Philippines  Xu-Hao Zhang, PhD, Maria Carmen Nievera, MD, Josefina Carlos, MD, Marilla Lucero, MD, PhD, Gyneth Bibera, MD, Maria Isabel Atienza, MD, Oleksandr Topachevskyi, PGDip, Cecilia Gretchen Navarro-Locsin, MD  Value in Health Regional Issues  Volume 3, Pages 156-166 (May 2014) DOI: 10.1016/j.vhri.2014.04.004 Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 1 Markov cohort model design. The cohort model is Markov-based with three exclusive health states: no disease, sequelae, and death. The transition from “no disease” to “sequelae” or “death” is calculated on the basis of this decision tree. In the model, only meningitis can lead to long-term sequelae; meningitis and bacteremia include NTHi meningitis and NTHi bacteremia, respectively; and nonconsulting AOM are accounted for in the quality-of-life impact calculation. AOM, acute otitis media; GP, general practitioner; NTHi, nontypeable Haemophilus influenzae; PCP, primary care physician; PCV13, pneumococcal 13-valent conjugate vaccine; PHiD-CV, pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D conjugate vaccine. Value in Health Regional Issues 2014 3, 156-166DOI: (10.1016/j.vhri.2014.04.004) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 2 Tornado diagram for the top 10 most influential parameters of the cost-effectiveness analysis of PHiD-CV 2 + 1 vaccination program versus no vaccination (one-way sensitivity analysis) in the Philippines. AOM, acute otitis media; CI, confidence interval; CAP, community-acquired pneumonia; GP, general practitioner; NTHi, nontypeable Haemophilus influenzae; PHiD-CV, pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D conjugate vaccine. Value in Health Regional Issues 2014 3, 156-166DOI: (10.1016/j.vhri.2014.04.004) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 3 Univariate sensitivity analysis comparing PHiD-CV with PCV13 in the Philippines. The effect of the nine most influential variables on cost-effectiveness results of the PHiD-CV 2 + 1 vaccination program versus the PCV13 2 + 1 strategy. AOM, acute otitis media; CI, confidence interval; GP, general practitioner; LL, lower limit; NTHi, nontypeable Haemophilus influenzae; PCV13, pneumococcal 13-valent conjugate vaccine; PHiD-CV, pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D conjugate vaccine; QALY, quality-adjusted life-year; UL, upper limit. Value in Health Regional Issues 2014 3, 156-166DOI: (10.1016/j.vhri.2014.04.004) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 4 Cost-effectiveness plane of probabilistic sensitivity analysis comparing PHiD-CV 2 + 1 with the no-vaccination strategy in the Philippines. PHiD-CV, pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D conjugate vaccine; QALY, quality-adjusted life-year. Value in Health Regional Issues 2014 3, 156-166DOI: (10.1016/j.vhri.2014.04.004) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 5 Cost-effectiveness plane of probabilistic sensitivity analysis comparing PHiD-CV 2 + 1 with no PCV13 2 + 1 in the Philippines. PCV13, pneumococcal 13-valent conjugate vaccine; PHiD-CV, pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D conjugate vaccine’ QALY, quality-adjusted life-year. Value in Health Regional Issues 2014 3, 156-166DOI: (10.1016/j.vhri.2014.04.004) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions