The authors stated that several possible Staphylococcus aureus
vaccines were in clinical development and they sought to determine if they were likely to be cost-effective.
The authors stated that the effectiveness data were identified by a review of the literature, but the details of this review were not reported. This makes it difficult to ascertain whether all the relevant evidence was included, but, given the hypothetical nature of this analysis, it is not clear that a more comprehensive review would add validity or weight to the results. The utilities were from the literature, but the methods used to elicit them and the populations, from which they were elicited, were not given. The use of QALYs will allow cross-disease comparisons, but without knowing the methods used to derive them, their suitability cannot be assessed.
The categories of costs reflected the stated perspective, but the costs were reported as category totals and the unit costs and resource quantities were not presented separately. This makes it difficult to replicate the analysis for other settings. The source of the data was described and other aspects of the cost study, such as the price year and inflation adjustments were reported.
Analysis and results:
The modelling seems to have been well conducted and was sufficiently reported. The incremental analysis was appropriate for identifying the best vaccination strategy. The parameter uncertainty was investigated, using a deterministic approach, and a number of alternative scenarios presented. The authors stated some limitations to their analysis, including their assumption that any vaccine brought to market would be safe and have no adverse effects.
: The modelling methods were valid, but there was limited reporting of the methods of identifying and selecting the model inputs. Given the hypothetical nature of the analysis and the lack of data on vaccine efficacy, the conclusions reflect the scope of the analysis.