Life-years lost were 24,867 with no vaccination and 15,128 with PCV-13 vaccination. Total pneumococcal disease direct medical costs were $512,479,479 with no vaccination and $259,870,832 with PCV-13 vaccination. Indirect costs were $446,720,173 with no vaccination and $254,406,795 with PCV-13 vaccination. The cost of the vaccination programme was $623,145,301. The incremental cost of vaccination was partly offset by reductions in other direct medical costs and indirect costs.
The incremental cost per life-year gained with vaccination over no vaccination was $38,045 from the payer perspective and $18,299 from the societal perspective. When considering a three-dose schedule, the corresponding figures were $22,050 and $2,304. All ratios were below the World Health Organization (WHO) cost-effectiveness criterion of three times the gross domestic product (GDP) per capita in Taiwan ($14,453).
Vaccine price was the most influential input. Base case findings were generally stable.
The probability of vaccination being cost-effective was 100% at a cost-effectiveness threshold of $37,634 (below the WHO benchmark) from the societal perspective and $57,311 (above the WHO benchmark) from the payer perspective.