Economic evaluations of vaccines in Canada: a scoping review

Rafferty, Ellen; Gagnon, Heather; Farag, Marwa; Waldner, Cheryl L.

doi:10.1186/s12962-017-0069-4

Cited by 5 publications

(3 citation statements)

References 75 publications

(96 reference statements)

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“…Systematic reviews of economic evaluation and of mathematical modeling studies are emerging in the published literature [ 35 ]. However, we identified several challenges in developing a high-quality systematic review and quantitative synthesis of economic evaluations.…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis

et al. 2018

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BackgroundPre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations. We aim to estimate the incremental cost per health outcome of PrEP compared with placebo, no PrEP, or other HIV prevention strategies; assess the methodological variability in, and quality of, economic evaluations of PrEP; estimate the incremental cost per health outcome of different PrEP implementation strategies; and quantify the potential sources of heterogeneity in outcomes.MethodsWe will systematically search electronic databases (MEDLINE, Embase) and the gray literature. We will include economic evaluation studies that assess both costs and health outcomes of PrEP in HIV-uninfected individuals, without restricting language or year of publication. Two reviewers will independently screen studies using predefined inclusion criteria, extract data, and assess methodological quality using the Philips checklist, Second Panel on the Cost-effectiveness of Health and Medicines, and the International Society for Pharmacoeconomics and Outcomes Research recommendations. Outcomes of interest include incremental costs and outcomes in natural units or utilities, cost-effectiveness ratios, and net monetary benefit. We will perform descriptive and quantitative syntheses using sensitivity analyses of outcomes by population subgroups, HIV epidemic settings, study designs, baseline intervention contexts, key parameter inputs and assumptions, type of outcomes, economic perspectives, and willingness to pay values.DiscussionFindings will guide future economic evaluation of PrEP strategies in terms of methodological and knowledge gaps, and will inform decisions on the efficient integration of PrEP into public health programs across epidemiologic and health system contexts.Systematic review registrationPROSPERO CRD42016038440.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0710-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis

et al. 2018

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“…Studies on economic evaluations such as the cost-effectiveness of pneumococcal vaccines among adults have been conducted in many countries with diverse outcomes [ 13 , 14 ]. The PPV23 was found to be cost-effective among the elderly aged ≥60 years in several studies.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness and budget impact analysis of PPV23 vaccination for the Malaysian Hajj pilgrims

Aminuddin

Zaimi²,

Kunusagaran³

et al. 2022

PLoS ONE

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The potential occurrence of disease outbreaks during the hajj season is of great concern due to extreme congestion in a confined space. This promotes the acquisition, spread and transmission of pathogenic microorganisms and pneumococcal disease are one of the most frequent infections among Hajj pilgrims. This study aimed to assess the cost-effectiveness and budget impact of introducing the PPV23 to Malaysian Hajj pilgrims. A decision tree framework with a 1-year cycle length was adapted to evaluate the cost-effectiveness of a PPV23 vaccination program with no vaccination. The cost information was retrieved from the Lembaga Tabung Haji Malaysia (LTH) database. Vaccine effectiveness was based on the locally published data and the disease incidence specifically related to Streptococcus pneumoniae was based on a literature search. Analyses were conducted from the perspective of the provider: Ministry of Health and LTH Malaysia. The incremental cost-effectiveness ratios (ICER), cases averted, and net cost savings were estimated. Findings from this study showed that PPV23 vaccination for Malaysian Hajj pilgrims was cost-effective. The PPV23 vaccination programme has an ICER of MYR -449.3 (US$-110.95) per case averted. Based on the national threshold value of US$6,200-US$8,900 per capita, the base-case result shows that introduction of the PPV23 vaccine for Malaysian Hajj pilgrims is very cost-effective. Sensitivity analysis revealed parameters related to annual incidence and hospitalised cost of septicemia and disease without vaccination as the key drivers of the model outputs. Compared with no vaccination, the inclusion of PPV23 vaccination for Malaysian Hajj pilgrims was projected to result in a net cost saving of MYR59.6 million and 109,996 cases averted over 5 years period. The PPV23 vaccination program could substantially offer additional benefits in reducing the pneumococcal disease burden and healthcare cost. This could be of help for policymakers to consider the implementation of PPV23 vaccination for Malaysian performing hajj.

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“…Moreover, metrics on vaccines are constantly shifting, with P/Ts needing to monitor vaccine effectiveness (including waning of immunity) and adverse events following immunization (AEFIs). With evolving programmatic complexity, accompanied by the advent of more technologically advanced vaccines, costs associated with vaccines have also increased in recent years [1]. Under these conditions, it is not surprising that the number of economic evaluations of vaccines, along with guidelines and methods to inform economic research in the area [1][2][3][4][5][6][7][8][9], have increased over time.…”

Section: Introductionmentioning

confidence: 99%

Using Health Economics to Inform Immunization Policy Across All Levels of Government

Rafferty

Reifferscheid

Assi

et al. 2022

PharmacoEconomics Open

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Publicly funded immunization programs have grown in both complexity and scope, resulting in increased costs and more complex programmatic decision making. Economic evaluations can provide crucial information to support informed decision making. While very few countries have National Immunization Technical Advisory Groups that analyze economic information, many have started to develop processes for this purpose. Since these guidelines are being developed at the national level, we propose that regional jurisdictions, especially those responsible for healthcare (e.g., provinces, territories, states), need clear processes for incorporating this information into their immunization decision making and program implementation. We interviewed Canadian vaccine experts involved in provincial vaccine policy decision making to identify current practices, perceptions, and recommendations around incorporating economic analysis into that process. Based on these interviews, we make five recommendations: (1) economic evidence should be routinely incorporated into the decision making process;(2) economic experts should sit on, or be available to, regional advisory committees; (3) efforts should be made to build on regional expertise by increasing educational opportunities on economic evaluation; (4) processes should include guidelines for when economic analysis is not required; and (5) clarification on the role of regional advisory groups in economic analysis is needed in relation to national expertise. The information presented here provides a starting point for regional health policy experts and decision makers to work collaboratively with national partners to create transparent and effective approaches to incorporating economic analysis into vaccine decision making.

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Economic evaluations of vaccines in Canada: a scoping review

Cited by 5 publications

References 75 publications

Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis

Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis

Cost-effectiveness and budget impact analysis of PPV23 vaccination for the Malaysian Hajj pilgrims

Using Health Economics to Inform Immunization Policy Across All Levels of Government

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