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Vaccines for the 21st Century: A Tool for Decisionmaking
Table A10–3 Health Care Costs Associated with Histoplasma Disease
% with Care
Cost per Unit
Units per Case
Form of treatment
Flu-like illness
(single state)
100%
$50
2.0
physician a
50%
$150
1.0
medication b, diagnostic b
Pneumonitis: outpatient only
(single state)
100%
$350
1.0
outpatient treatment 2 physician b, medication b, diagnostic b
outpatient—3 months (8 physician b, 3 medicaion c)
recovery
50%
$1,250
1.0
outpatient—3 months
Chronic pulmonary
symptomatic (untreated, initial treatment)
40%
$5,000
1.0
hospitalization
outpatient treatment
100%
$1,250
3.0
outpatient (same as for disseminated disease)
Using committee assumptions of time and costs until licensure, the fixed cost of vaccine development has been amortized and is $10.8 million for a H. capsulatum vaccine.
If a vaccine program were implemented today and the vaccine were 100% efficacious and utilized by 100% of the target population, the annualized present value of the cost per QALY gained is $300,000. Using committee assumptions of less-than-ideal utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the cost per QALY gained is $600,000.
See Chapters 4 and 5 for details on the methods and assumptions used by the committee for the results reported.