A state-transition Markov model was constructed to determine the clinical and cost-effectiveness of the vaccination programmes. A five-year time horizon was used and the author stated that the perspective was that of the health care provider.
The effectiveness data were from selected published papers, which were mainly of observational and health economic studies. The main clinical parameters were the efficacy of vaccination, complications following vaccination, the transmission rate for measles, and the coverage of vaccination.
Monetary benefit and utility valuations:
Disability weights were derived from the Global Burden of Disease Study.
Measure of benefit:
The measure of benefit was disability-adjusted life-years (DALYs) gained and these were discounted at 3% per annum.
The direct costs included those of the vaccine; transport, administration, and waste disposal associated with the vaccine; and the vaccination and surveillance campaign. The drug unit costs and associated costs were from the National Policy for Universal Immunization Program in India (Ministry of Health and Family Welfare, Government of India. 2008, see ‘Other Publications of Related Interest’ below for bibliographic details). The campaign costs were from the National Pulse Polio campaign. These costs were in Indian rupees (INR).
Analysis of uncertainty:
One-, two- and three-way sensitivity analyses were performed to assess the impact of uncertainty in the probability that the vaccine produced immunity, the probability of developing measles, and the vaccination rates achieved.