3. How comprehensive can we be in the economic assessment of vaccines?

Abstract

In two previous papers we argued on current vaccines economic assessment not fully comprehensive when using the incremental cost-utility analysis normally applied for treatments. Many differences exist between vaccines and drug treatments making vaccines economic evaluation more cumbersome. Four challenges overwhelmingly present in vaccines assessment are less important for treatments: requirements for population, societal perspectives, budget impact evaluation, and time focused objectives (control or elimination). Based on this, economic analysis of vaccines may need to be presented to many different stakeholders with various evaluation preferences, in addition to the current stakeholders involved for drugs treatment assessment. Then, we may need a tool making the inventory of the different vaccines health economic assessment programmes more comprehensive. The cauliflower value toolbox has been developed with that aim, and its use is illustrated here with rotavirus vaccine. Given the broader perspectives for vaccine assessment, it provides better value and cost evaluations. Cost-benefit analysis may be the preferred economic assessment method when considering substitution from treatment to active medical prevention. Other economic evaluation methods can be selected (i.e. optimisation modelling, return on investment) when project prioritisation is the main focus considered and when stakeholders would like to influence the development of the healthcare programme.

How to assess for the full economic value of vaccines? From past to present, drawing lessons for the future

“…The following three elements have helped us in identifying the current list of available methods. First, our internal evaluation comparing treatment with vaccine prevention identified 24 items that could be regrouped into four domains (population focus, societal perspective, budget need, and different role functions of the vaccine over time [6]). This was followed by further investigation on 'budget need' evaluations independent of CEA, such as budget impact analysis (BIA), CBA, CO, and Cobb-Douglas evaluation functions.…”

“…During the last 15 years, research has identified different stakeholders interested in vaccines and their value assessment [6]. This is reflected in the assessment of factors such as a need for acceptance by the target population (e.g., for HPV vaccination against cervical cancer), or the recognition that much of the benefit of some of the newer vaccines could be seen by nonmedical stakeholders including employers, employees or financial authorities.…”

“…Vaccines may have value to stakeholders beyond healthcare decision-makers and consequently, the value measurement must be broader than the clinical gain. A range of outcome measures linked to additional analysis methods are needed to account for the variation in economic and healthcare development with the introduction of vaccines [6,7]. Vaccines are meaningfully evaluated in terms of avoiding or reducing risk for losing some quality-adjusted life-years (QALY), using plans and programs that target specific populations to control infection spread [8,9].…”

Recent Progress on the Versatility of Virus-Like Particles

“…Vaccination is one of the most cost-effective ways to control and prevent the spread of infectious disease [1]. Pathogens and their metabolites are prepared as an immunological formulation that can be used to prevent or treat infectious diseases by artificial attenuation, detoxification, inactivation, or genetic engineering methods [2].…”

Sustainable vaccine development: a vaccine manufacturer's perspective

“…From 2001 to 2020, the broader benefits could amount to a staggering US$ 820 billion in the 73 countries supported by the Global Alliance for Vaccines and Immunization (GAVI) [2], a public-private partnership (PPP) involving amongst others the UN, the vaccine industry and the Bill and Melinda Gates Foundation (BMGF). Due to the higher disease burden and more limited medical infrastructure, the HE gain from introducing a vaccine in LMICs will be greater than in higher-income countries (HICs), where the gain will largely be determined by competition between the different health options on offer [3].…”