Table 3

Cost-effectiveness of disregarding the restrictive BCG vial-opening policy for the Guinea-Bissau birth cohort in 2017

Restrictive (baseline) scenarioNon-restrictive scenario
No of children born in health facilities33 35433 354
No of children BCG-vaccinated at birth13 43833 354
No of children not BCG-vaccinated at birth55 77435 858
BCG coverage at 12 months of age93 %99 %
Total household costs of seeking BCG vaccinationUS$134 631US$68 694
Total BCG vaccine costsUS$26 221US$279 769
Total injection supply costsUS$3909US$6640
TB-specific effects only Median (95% uncertainty range) Median (95% uncertainty range)
No of paediatric TB deaths33 (13 to 89)29 (11 to 79)
LYG by averted TB death195 (7 to 817)
LYG by averted TB death—discounted95 (4 to 397)
No of paediatric TB hospital admissions46*41 (33 to 46)
Costs of TB hospital admissionsUS$51 207US$45 557
Costs of TB hospital admissions discountedUS$47 011US$41 813
Incremental costs of disregarding the restrictive vial-opening policy (including vaccination costs, household costs and costs averted by TB hospital admissions)US$184 692
Incremental costs of disregarding the restrictive vial-opening policy discountedUS$185 144
ICER per LYG (USD)440 (69 to 4440)
ICER per LYG discounted (USD)911 (145 to 9142)
ICER per TB death averted (USD)24 269 (3827 to 2 44 869)
ICER per TB death averted discounted (USD)26 527 (4225 to 2 66 291)
All-cause effects Median (95% uncertainty range) Median (95% uncertainty range)
No of all-cause deaths4820 (4309 to 5425)4429 (3920 to 5028)
LYG by averted all-cause deaths22 166 (8949 to 35 288)
LYG by averted all-cause deaths—discounted10 605 (4279 to 16 896)
No of all-cause hospital admissions5926 (5538 to 6346)5940 (5532 to 6380)
Costs of all-cause hospital admissionsUS$549 815US$551 478
Costs of all-cause hospital admissions discountedUS$508 556US$510 076
Incremental costs of disregarding the restrictive vial-opening policy (including vaccination costs, household costs and costs averted by hospital admissions)US$192 005
Incremental costs of disregarding the restrictive vial-opening policy discountedUS$191 863
ICER per LYG (USD)4 (3 to 11)
ICER per LYG discounted (USD)9 (5 to 23)
ICER per all-cause death averted (USD)249 (144 to 615)
ICER per all-cause death averted discounted (USD)259 (150 to 639)
  • *The number of paediatric TB hospital admissions is the reported number of TB cases from Guinea-Bissau in 2017 (Programa Nacional de Luta contra a Tuberculose. Relatório anualde tuberculose 2017: Ministério da Saúde Publica da Guiné-Bissau, 2018).

  • ICER, incremental cost-effectiveness ratio; LYG, life-year gained; USD, US dollar 2017 value.