Cost Effectiveness of the New Pneumococcal Vaccines: A Systematic Review of European Studies

Vooren, Katelijne van de; Duranti, Silvy; Curto, Alessandro; Garattini, Livio

doi:10.1007/s40273-013-0113-y

Cited by 28 publications

(24 citation statements)

References 83 publications

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“…Additional literature, i.e. three papers specifically on pneumococal vaccines [42–44] and a public report from the Product Development Partnership PATH [45] were reviewed. This was supplemented by a review of the clinical trial database ClinicalTrials.gov at the point in time of the research (mid-2015) to get an up-to-date picture on the status of vaccines under development, as well as by cross-checking against relevant company websites.…”

Section: Methodsmentioning

confidence: 99%

An assessment of the future impact of alternative technologies on antibiotics markets

Nwokoro

Leach²,

Årdal

et al. 2016

J of Pharm Policy and Pract

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BackgroundThe increasing threat of antimicrobial resistance combined with the paucity of new classes of antibiotics represents a serious public health challenge. New treatment technologies could, in theory, have a significant impact on the future use of traditional antibiotics, be it by facilitating rational and responsible use or by product substitution in the existing antibiotics markets, including by reducing the incidence of bacterial infections through preventative approaches. The aim of this paper is to assess the potential of alternative technologies in reducing clinical use of and demand for antibiotics, and to briefly indicate which segments of the antibiotics market that might be impacted by these technologies.MethodsAn initial mapping exercise to identify the alternative technologies was followed by a review of relevant published and grey literature (n = 52). We also carried out stakeholder engagement activities by a round-table discussion with infectious disease specialists and a multi-criteria decision analysis exercise with pharmaceutical industry experts.ResultsTen alternative technologies were identified and analyzed for their potential impact on the antibiotics market. Of these, rapid point-of-care diagnostics, vaccines, fecal microbiota transplantation, and probiotics were considered to have a “high” or “medium” potential impact over a 10-20 year horizon. Therapeutic antibodies, antibiotic biomaterials, bacteriophages, antimicrobial nanoparticles, antimicrobial peptides, and anti-virulence materials were rated as having “low” potential impact.ConclusionDespite the apparent potential of the most promising alternative technologies to reduce demand, that reduction will likely only happen in limited segments of the antibiotics market or, in the case of preventing community acquired streptococcal infections by vaccination, in a low-price generics market segment. Thus, alternative technologies are not expected to represent any disincentive to antibiotics developers. Finally, it is unlikely that alternative technologies will displace the need for new classes, and sub-classes, of antibiotics in the short and medium terms.

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Section: Methodsmentioning

confidence: 99%

An assessment of the future impact of alternative technologies on antibiotics markets

Nwokoro

Leach²,

Årdal

et al. 2016

J of Pharm Policy and Pract

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“…We examined how discounting is used in economic evaluations of vaccination reviewed in six recent systematic reviews of economic evaluations of vaccines against human papillomavirus [17] (n = 12); Streptococcus pneumoniae [18] (n = 15), [19] (n = 10); rotavirus [20] (n = 17); Haemophilus influenzae type B [21] (n = 13); and seasonal influenza [22] (n = 18).…”

Section: Methodsmentioning

confidence: 99%

Discounting in the evaluation of the cost-effectiveness of a vaccination programme: A critical review

Jit

Mibei

2015

Vaccine

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Discounting future costs and health benefits usually has a large effect on results of cost-effectiveness evaluations of vaccination because of delays between the initial expenditure in the programme and the health benefits from averting disease. Most guidelines currently recommend discounting both costs and health effects at a positive, constant, common rate back to a common point in time. A review of 84 published economic evaluations of vaccines found that most of them apply these recommendations. However, both technical and normative arguments have been presented for discounting health at a different rate to consumption (differential discounting), discounting at a rate that changes over time (non-constant discounting), discounting intra-generational and inter-generational effects at a different rate (two-stage discounting), and discounting the health gains from an intervention to a different discount year from the time of intervention (delayed discounting). These considerations are particularly acute for vaccines, because their effects can occur in a different generation from the one paying for them, and because the time of vaccination, of infection aversion, and of disease aversion usually differ. Using differential, two-stage or delayed discounting in model-based cost-effectiveness evaluations of vaccination raises technical challenges, but mechanisms have been proposed to overcome them.

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“…As recently underlined by the national Antitrust Authority (Autorità Garante della Concorrenza e del Mercato, AGCM) [8], potential competition may be exploited further for traditional vaccinations, owing to new multivalent vaccines being marketed (two hexavalent for diphtheriahepatitisB-pertussis-polio-tetanus-haemophilus influenza b and two quadrivalent for measles-rubellaparotitis-varicella), for HPV and PCV vaccinations, although with very uneven results for the two last ones so far -impressive for HPV [9] and negligible for PCV [2]. While the male extension for HPV could contribute to a further decrease of the prices awarded in regional tenders (€28.60 per dose [10] the lowest at present), the combined schedule of PCV13 and PPV23 foreseen for the extension of pneumococcal vaccination to older adults will preclude any kind of price competition in practice, although the difference between the two vaccines is less relevant for this target population [11,12]. There is little potential competition for herpes zoster and meningococcal vaccines, since only one manufacturer markets them, while two vaccines are available against rotavirus.…”

Section: Policy Implicationsmentioning

confidence: 99%

Vaccination planning in Italy: increasing vaccines while reducing coverage?

Garattini

Curto

Freemantle

2016

Expert Review of Pharmacoeconomics & Outcomes Research

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Cost Effectiveness of the New Pneumococcal Vaccines: A Systematic Review of European Studies

Cited by 28 publications

References 83 publications

An assessment of the future impact of alternative technologies on antibiotics markets

An assessment of the future impact of alternative technologies on antibiotics markets

Discounting in the evaluation of the cost-effectiveness of a vaccination programme: A critical review

Vaccination planning in Italy: increasing vaccines while reducing coverage?

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