The private demand for an AIDS vaccine in Thailand

Suraratdecha, Chutima; Ainsworth, Martha; Tangcharoensathien, Viroj; Whittington, Dale

doi:10.1016/j.healthpol.2004.05.005

Cited by 27 publications

(30 citation statements)

References 11 publications

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“…Cost arose as an important concern across all populations, as identified in previous investigations of HIV vaccine acceptability in Thailand among MSM ) and the general public (Suraratdecha et al 2005). Although acknowledged as a desired product, existing vaccines were often perceived as a luxury for the rich; out-of-pocket costs for a vaccine that might prevent a disease that could affect one in the future were weighed against immediate needs for survival.…”

Section: Discussionmentioning

confidence: 99%

A social vaccine? Social and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand

Newman

Roungprakhon

Tepjan

et al. 2012

Global Public Health

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A safe and efficacious preventive HIV vaccine would be a tremendous asset for low- and middle-income country (LMIC) settings, which bear the greatest global impact of AIDS. Nevertheless, substantial gaps between clinical trial efficacy and real-world effectiveness of already licensed vaccines demonstrate that availability does not guarantee uptake. In order to advance an implementation science of HIV vaccines centred on LMIC settings, we explored sociocultural and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand, the site of the largest HIV vaccine trial ever conducted. Cross-cutting challenges for HIV vaccine uptake - social stigma, discrimination in healthcare settings and out-of-pocket vaccine cost - emerged in addition to population-specific barriers and opportunities. A 'social vaccine' describes broad sociocultural and structural interventions - culturally relevant vaccine promotion galvanised by communitarian norms, mitigating anti-gay, anti-injecting drug user and HIV-related stigma, combating discrimination in healthcare, decriminalising adult sex work and injecting drug use and providing vaccine cost subsidies - that create an enabling environment for HIV vaccine uptake among most-at-risk populations. By approaching culturally relevant social and structural interventions as integral mechanisms to the success of new HIV prevention technologies, biomedical advances may be leveraged in renewed opportunities to promote and optimise combination prevention.

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Section: Discussionmentioning

confidence: 99%

A social vaccine? Social and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand

Newman

Roungprakhon

Tepjan

et al. 2012

Global Public Health

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show abstract

“…Stated preference studies have been routinely used in environmental economics for nonmarketed goods or services (see Venkatachalam, 2004, for a useful literature review of the method and its strengths and weaknesses) and have more recently been used for vaccines that are either locally unavailable, for example, a cholera vaccine in Kolkata (see Canh et al, 2006;Cook et al, 2007;Lucas et al, 2007;Islam et al, 2008;Kim et al, 2008;Whittington et al, 2008), or have not yet been invented (for example, an HIV/AIDS vaccine- Whittington, Pinheiro, & Cropper, 2003;Cropper et al, 2004;Suraratdecha et al, 2005).…”

Section: Private Demandmentioning

confidence: 99%

Using private demand studies to calculate socially optimal vaccine subsidies in developing countries

Cook

Jeuland

Maskery

et al. 2008

J Policy Anal Manage

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Although it is well known that vaccines against many infectious diseases confer positive economic externalities via indirect protection, analysts have typically ignored possible herd protection effects in policy analyses of vaccination programs. Despite a growing literature on the economic theory of vaccine externalities and several innovative mathematical modeling approaches, there have been almost no empirical applications. The first objective of the paper is to develop a transparent, accessible economic framework for assessing the private and social economic benefits of vaccination. We also describe how stated preference studies (for example, contingent valuation and choice modeling) can be useful sources of economic data for this analytic framework. We demonstrate socially optimal policies using a graphical approach, starting with a standard textbook depiction of Pigouvian subsidies applied to herd protection from vaccination programs. We also describe nonstandard depictions that highlight some counterintuitive implications of herd protection that we feel are not commonly understood in the applied policy literature. We illustrate the approach using economic and epidemiological data from two neighborhoods in Kolkata, India. We use recently published epidemiological data on the indirect effects of cholera vaccination in Matlab, Bangladesh (Ali et al., 2005) for fitting a simple mathematical model of how protection changes with vaccine coverage. We use new data on costs and private demand for cholera vaccines in Kolkata, India, and approximate the optimal Pigouvian subsidy. We find that if the optimal subsidy is unknown, selling vaccines at full marginal cost may, under some circumstances, be a preferable second-best option to providing them for free.

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“…Few studies have adopted a contingent valuation approach to estimate WTP for hypothetical HIV vaccines (e.g. see [14][15][16]). This approach involves presenting the respondents with one or a small number of scenarios that include a price for a hypothetical vaccine of given attributes, then adjusting the price in several steps in order to determine the respondent's maximum willingness-to-pay for each vaccine scenario [17].…”

Section: Introductionmentioning

confidence: 99%

The marginal willingness-to-pay for attributes of a hypothetical HIV vaccine

Cameron

Newman

Roungprakhon

et al. 2013

Vaccine

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This paper estimates the marginal willingness-to-pay for attributes of a hypothetical HIV vaccine using discrete choice modeling.We use primary data from 326 respondents from Bangkok and Chiang Mai, Thailand, in 2008-2009, selected using purposive, venue-based sampling across two strata. Participants completed a structured questionnaire and full rank discrete choice modelling task administered using computer-assisted personal interviewing. The choice experiment was used to rank eight hypothetical HIV vaccine scenarios, with each scenario comprising seven attributes (including cost) each of which had two levels. The data were analyzed in two alternative specifications: (1) best-worst; and (2) full-rank, using logit likelihood functions estimated with custom routines in Gauss matrix programming language.In the full-rank specification, all vaccine attributes are significant predictors of probability of vaccine choice. The biomedical attributes of the hypothetical HIV vaccine (efficacy, absence of VISP, absence of side effects, and duration of effect) are the most important attributes for HIV vaccine choice. On average respondents are more than twice as likely to accept a vaccine with 99% efficacy, than a vaccine with 50% efficacy. This translates to a willingness to pay US$383 more for a high efficacy vaccine compared with the low efficacy vaccine.Knowledge of the relative importance of determinants of HIV vaccine acceptability is important to ensure the success of future vaccination programs. Future acceptability studies of hypothetical HIV vaccines should use more finely-grained biomedical attributes, and could also improve the external validity of results by including more levels of the cost attribute.

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The private demand for an AIDS vaccine in Thailand

Cited by 27 publications

References 11 publications

A social vaccine? Social and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand

A social vaccine? Social and structural contexts of HIV vaccine acceptability among most-at-risk populations in Thailand

Using private demand studies to calculate socially optimal vaccine subsidies in developing countries

The marginal willingness-to-pay for attributes of a hypothetical HIV vaccine

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