Value in Health Regional Issues Economic Impact of Pneumococcal Protein-D Conjugate Vaccine (PHiD-CV) on the Malaysian National Immunization Programme  Syed Aljunid, MD, MsC, PhD, FAMM, Namaitijiang Maimaiti, LL.B, MsC, PhD, Zafar Ahmed, MBBCH, MBA, PhD, Amrizal Muhammad Nur, MD, MsC, PhD, Zaleha Md Isa, PhD, Soraya Azmi, MD, MPH, Saperi Sulong, MD, PhD  Value in Health Regional Issues  Volume 3, Pages 146-155 (May 2014) DOI: 10.1016/j.vhri.2014.04.008 Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 1 Markov cohort model. 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, pneumonia has only short-term sequelae whereas 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; PCP, primary care physician; NTHi, nontypeable Haemophilus influenzae. Value in Health Regional Issues 2014 3, 146-155DOI: (10.1016/j.vhri.2014.04.008) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 2 Tornado diagram of one-way sensitivity analysis of the effect of the 10 most influential variables on the cost-effectiveness results of PHiD-CV vs. no vaccination. Note: Red bars indicate the effect of high sensitivity values, and blue bars indicate the effect of low sensitivity values on the ICER per QALY gained of PHiD-CV vs. no vaccination. ICER, incremental cost-effectiveness ratio; PHiD-CV, pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine; QALY, quality-adjusted life-year. Value in Health Regional Issues 2014 3, 146-155DOI: (10.1016/j.vhri.2014.04.008) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions

Fig. 3 Tornado diagram of one-way sensitivity analysis of the effect of the 10 most influential variables on the cost-effectiveness results of PHiD-CV vs. PCV13. Note: Red bars indicate the effect of high sensitivity values, and blue bars indicate the effect of low sensitivity values on the ICER per QALY gained of PHiD-CV vs. no vaccination. ICER, incremental cost-effectiveness ratio; PCV13, 13-valent pneumococcal cunjugate vaccine; PHiD-CV, pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine; QALY, quality-adjusted life-year. Value in Health Regional Issues 2014 3, 146-155DOI: (10.1016/j.vhri.2014.04.008) Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Terms and Conditions