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Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 17: Neisseria gonnorrhea
Pages 257-266

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From page 257...
... Consequences of PID are assumed to occur with a 5-year lag from infection and include ectopic pregnancy, chronic pelvic pain, and infertility. The health utility index and length of time spent in the health state range from .85 HUI for 7 days (cervicitis)
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From page 258...
... 0.00 32.48 124.60 1,749.84 777.54 90.38 36.54 26.73 0.00 0.00 0.00 419.63 Female Age Groups Population % Distribution of Cases Cases 0.0000 0.0050 0.0450 0.6000 0.3000 0.0350 0.0100 0.0050 0.0000 0.0000 0.0000 1.0000 % Distribution of Cases Cases 0.0000 0.0050 0.0450 0.6000 0.3000 0.0350 0.0100 0.0050 0.0000 0.0000 0.0000 1.0000 <1 1 -4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Total 1,933,000 7,905,000 18,554,000 17,747,000 20,835,000 21,238,000 15,447,000 11,140,000 10,544,000 6,814,000 2,593,000 134,750,000 Male Population 2,030,000 8,314,000 19,502,000 18,516,000 20,835,000 20,911,000 14,777,000 10,101,000 8,420,000 4,274,000 1,005,000 128,685,000 o 2,300 20,700 276,000 138,000 16,100 4,600 2,300 o o o 460,000 Age Groups <1 1 -4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Total 2,700 24,300 324,000 162,000 18,900 5,400 2,700 o o o 540,000 For the purposes of the calculations in this report, the committee assumed that 15% of cases in men are asymptomatic and untreated. The overwhelming utility index and length of time spent in the health state range from .85 HUI for 7 days (cervicitis)
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From page 259...
... 22.7313 (remaining lifetime at onset +5 years) discounted quality adjusted life expectancy at age 28.7 22.7313 (remaining lifetime at onset + 5 years)
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From page 260...
... , health care costs include a limited visit with a physician and inexpensive diagnostics and medications. Disseminated gonococcal infections in both women and men were assumed to be associated with inpatient costs (hospitalization, diagnostics, specialist physicians)
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From page 261...
... inpatient and outpatient 100% $1,550 1 outpatient laparoscopy ALL PID sequelae: 5-year lag from infection Ectopic Pregnancy Outpatient PID sequela: 5-year lag outpatient only 100% $1,000 1 laparoscopy 100% $500 1 surgical staff 100% $500 1 surgical staff 100% $50 1 diagnostic a 100% $100 1 physician b Continued
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From page 262...
... hospitalization surgical staff surgical staff tubal surgery (30% of those seeking treatment) outpatient surgery surgeon anesthesiology in vitro fertilization (12% of those seeking treatment)
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From page 263...
... - inpatient 100% $100 100% 100% 2 physician b $50 1 culture gonorrhea $50 1 medication 100% $3,000 1 hospitalization 100% $150 3 physician c 100% $50 1 diagnostic a 100% $50 1 medication b outpatient after inpatient $100 1 physician b MEN Asymptomatic (untreated) Urethritis 100% $50 1 physician a 100% $50 1 diagnostic a Epididymitis outpatient 100% $100 1 physician b 100% $50 1 physician a 100% $50 1 diagnostic a 100% $50 1 medication b Epididymitis inpatient 100% $3,000 1 hospitalization 100% $150 3 physician c 100% $50 1 physician a 100% $50 1 medication b 50% $500 1 surgical staff 50% $500 1 surgical staff Disseminated gonococcal infections (bacteremia, arthritis, etc.
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From page 264...
... This includes hysterosalphoingography, outpatient laparoscopy, tubal surgery, and infertility treatment. Epididymitis in men was estimated to be treated primarily on an outpatient basis and includes costs for both limited visits and specialist physician visits, diagnostics, and medications.
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From page 265...
... gonorrhea were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the health care costs saved would be $440 million. Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $92.1 million.
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Key Terms

  • target population
  • gonorrhea infection
  • care costs
  • committee assumptions
  • chronic pelvic

  • pelvic pain
  • using committee
  • outpatient laparoscopy
  • monetary costs
  • including time

  • gonorrhea infections
  • health state
  • physician visits
  • life expectancy
  • qalys gained

  • qaly gained
  • quality adjusted
  • vaccine development
  • summarizes vaccine
  • outpatient costs

  • state range
  • vaccines considered
  • costs include
  • disseminated gonococcal
  • gonococcal infections

  • adjusted life
  • specialist physicians
  • costs saved
  • program cost
  • discounted quality


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