Optimising the introduction of multiple childhood vaccines in Japan: A model proposing the introduction sequence achieving the highest health gains

Standaert, Baudouin; Schecroun, N; Ethgen, Olivier; Topachevskyi, O.; Morioka, Y; Vlaenderen, I Van

doi:10.1016/j.healthpol.2017.08.010

Cited by 7 publications

(16 citation statements)

References 37 publications

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“…We have been able to provide overviews of full immunization programs developed using portfolio models. Examples include: showing the cost offsets and health gains of different dosing schemes using different vaccines for the same indication under a constrained budget (rotavirus vaccination) [41]; prioritising different intervention types to manage paediatric infections, and malaria [42,44]; demonstrating the benefit of child vaccination for working mothers with evidence of reduced work absenteeism [87]; improving QoC with vaccination and translating this into cost gains while maintaining QoC [50,60]; estimating the best combination of vaccination and screening to maximise cervical cancer reduction under a fixed budget [40]; and showing that extra budget does not guarantee substantial health gain in aging adults from PCV and/or influenza vaccination [43].…”

Section: Discussionmentioning

confidence: 99%

“…CO offers greater transparency than CEA, as instead of a threshold it uses an actual budget constraint that restricts the acceptance of intervention types. It provides richer information than CEA as it directly links budget and outcome, can generate budget plans for reaching health goals, and clarifies the connection between budget and impacts, helping to prioritise more clearly than CEA combined with BIA [44]. The method has a long history of application outside healthcare, with a proven record of benefit in domains such as fishery, forestry, agriculture and industry, among others [79].…”

Section: Budget-focused Methodsmentioning

confidence: 99%

“…Portfolio assessment assigns a priority to the introduction of specific vaccines when budgets are limited, while seeking to optimise outcomes such as QALYs gained, hospitalisations avoided, or direct medical cost reduction [44].…”

Section: Budget-focused Methodsmentioning

confidence: 99%

“…The advent of many new vaccines within a short period also encouraged the reappearance of CO models evaluating the best combination of interventions including vaccines to optimise health benefit within and across specific diseases under specific constraints [40][41][42][43]. CO could also help decision-makers to prioritise the introduction of vaccination programs [44]. One of the most recent areas of new research involved the use of fiscal health models (FHM) and social accounting matrix (SAM) modelling to better identify the indirect costs saved with vaccination [45,46].…”

Section: A Historical Perspective On the Economic Evaluation Of Vaccinesmentioning

confidence: 99%

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

Standaert

Sauboin

DeAntonio³

et al. 2020

Journal of Market Access & Health Policy

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Background:Cost-effectiveness analysis (CEA) is the economic analysis method most commonly applied today in the context of replacing one treatment with a new one in a developed healthcare system to improve efficiency. CEA is often requested by local healthcare decisionmakers to grant reimbursement.New preventative interventions, such as new vaccines, may however have much wider benefits inside and outside healthcare, when compared with treatment. These additional benefits include externalities on indirect clinical impact, reallocation of specific healthcare resources, improved quality of care, better productivity, better disease control, better fiscal revenues, and others. But these effects are sometimes difficult to integrate into a meaningful CEA result. They may appear as specific benefits for specific stakeholders, other than the stakeholders in healthcare.Objective: Based on a historical view about the application of economic assessments for vaccines our objective has been to make the inventory of who was/is interested in knowing the economic value of vaccines, in what those different stakeholders are likely to see the benefit from their perspective and how were/are we able to measure those benefits and to report them well. Results: The historical view disclosed a limited interest in the economic assessment of vaccines at start, more than 50 years ago, that was comparable to the assessment of looking for more efficiency in new industries through optimization exercises. Today, we are exposed to a very rich panoply of different stakeholders (n= 16). They have their specific interest in many different facets of the vaccine benefit of which some are well known in the conventional economic analysis (n=9), but most outcomes are hidden and not enough evaluated and reported (n=26). Meanwhile we discovered that many different methods of evaluation have been explored to facilitate the measurement and reporting of the benefits (n=18). Conclusion: Our recommendation for future economic evaluations of new vaccines is therefore to find the right combination among the three entities of stakeholder type selection, outcome measure of interest for each stakeholder, and the right method to apply. We present at the end examples that illustrate how successful this approach can be.

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Section: Discussionmentioning

confidence: 99%

Section: Budget-focused Methodsmentioning

confidence: 99%

Section: Budget-focused Methodsmentioning

confidence: 99%

Section: A Historical Perspective On the Economic Evaluation Of Vaccinesmentioning

confidence: 99%

See 2 more Smart Citations

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

Standaert

Sauboin

DeAntonio³

et al. 2020

Journal of Market Access & Health Policy

Self Cite

View full text Add to dashboard Cite

show abstract

“…Also, herd effect was not applied in the PMMFV, as we have done in other portfolio models through approximations of increased vaccine effectiveness and/or vaccine coverage rate [34]. It was not considered as an option because if one vaccine is more effective, its herd effect will be more pronounced, thereby inflating its ROI without affecting its sequence in the ranking.…”

Section: Limitationsmentioning

confidence: 99%

Constrained Optimization for the Selection of Influenza Vaccines to Maximize the Population Benefit: A Demonstration Project

Standaert

Vlaenderen

Bellinghen

et al. 2019

Appl Health Econ Health Policy

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Background Influenza is an infectious disease causing a high annual economic and public health burden. The most efficient management of the disease is through prevention with vaccination. Many influenza vaccines are available, with varying efficacy and cost, targeting different age groups. Therefore, strategic decision-making about which vaccine to deliver to whom is warranted to improve efficiency. Objective We present the use of a constrained optimization (CO) model to evaluate targeted strategies for providing influenza vaccines in three adult age groups in the USA. Methods CO was considered for identifying an influenza vaccine provision strategy that maximizes the benefits at constrained annual budgets, by prioritizing vaccines based on return on investment. The approach optimizes a set of predefined outcome measures over several years resulting from an increasing investment using the best combination of influenza vaccines. Results Results indicate the importance of understanding the relative differences in benefits for each vaccine type within and across age groups. Scenario and threshold analyses demonstrate the impact of changing budget distribution over time, price setting per vaccine type, and selection of outcome measure to optimize. Conclusion Significant gains in cost efficiency can be realized for a decision maker using a CO model, especially for a disease like influenza with many vaccine options. Testing the model under different scenarios offers powerful insights into maximum achievable benefit overall and per age group within the predefined constraints of a vaccine budget. Electronic supplementary material The online version of this article (10.1007/s40258-019-00534-y) contains supplementary material, which is available to authorized users.

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Data-Related Challenges in Cost-Effectiveness Analyses of Vaccines

Pike

Leidner

Chesson

et al. 2022

Appl Health Econ Health Policy

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Optimising the introduction of multiple childhood vaccines in Japan: A model proposing the introduction sequence achieving the highest health gains

Abstract: The PMV model could be a helpful tool for decision makers in those environments with limited budget where vaccines have to be selected for trying to optimise specific health goals.

Cited by 7 publications

References 37 publications

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

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

Constrained Optimization for the Selection of Influenza Vaccines to Maximize the Population Benefit: A Demonstration Project

Data-Related Challenges in Cost-Effectiveness Analyses of Vaccines

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