Towards a more comprehensive approach for a total economic assessment of vaccines?

Abstract

ABSTRACT​Since we were born, we all take preventative actions to avoid unpredictable adverse conditions. Some actions are done automatically. Others require a conscious choice , either for personal or social benefit. A distinction can therefore be drawn between non-active and active prevention, and between individual and social prevention. Active prevention requires making a choice in time, effort, and cost. We call it an economic choice. Vaccines belong to the group of active and social prevention. Because a vaccination program is an economic social choice, how should it be valued, and what cost should we pay for? To date, the economic evaluations developed for treatment have been applied to vaccines. However, over 25 different characteristics differentiate vaccines from treatment. For example, the benefit of vaccination is measured at the population level not at the individual level, the main effect of prevention is societal and not an individual-based gain only, and the biggest hurdle to implement a new vaccine is the initial budget investment and not so much its estimated ‘value for money’. This makes the current application of incremental cost-utility analysis difficult for vaccines for a comprehensive evaluation. New approaches may be needed to capture the full economic benefit of vaccines.​

Health Technology Assessment and priority setting for Universal Health Coverage: A qualitative study of stakeholders capacity, needs, policy areas of demand and perspectives in Nigeria

“…Knowing these priority areas will be helpful in devising a relevant HTA capacity strengthening program. The result is similar to the use of HTA in India [34].…”

Health technology assessment and priority setting for universal health coverage: a qualitative study of stakeholders’ capacity, needs, policy areas of demand and perspectives in Nigeria

“…However, surprisingly public health programs were prioritized over medicines and vaccines that are usually the exclusive domain of HTA. Decision makers are usually interested in two different financial forces (less budget for more demand and more supply at a higher price) and as a result they tend to channel each request for new investment through an evaluation process, assessing the effectiveness of the new programmes or products in real-life situations and whether the money spent is good value for health and for the healthcare programme as opposed to efficacy from randomised clinical trials; and whether it is worth buying the new asset given the limitations that exist [35]. The WHO road map for access to medicines, vaccines and other health products, 2019-2023, aligns with the outputs that have been identified within the WHO framework including provision of authoritative guidance and standards on the quality, safety and efficacy of health products, access to essential medicines, vaccines, diagnostics and devices for PHC [36].…”

Health Technology Assessment and priority setting for Universal Health Coverage: A qualitative study of stakeholders capacity, needs, policy areas of demand and perspectives in Nigeria

“…However, surprisingly public health programs were prioritized over medicines and vaccines that are usually the exclusive domain of HTA. Decision makers are usually interested in two different financial forces (less budget for more demand and more supply at a higher price) and as a result they tend to channel each request for new investment through an evaluation process, assessing the effectiveness of the new programmes or products in real-life situations and whether the money spent is good value for health and for the healthcare programme as opposed to efficacy from randomised clinical trials; and whether it is worth buying the new asset given the limitations that exist [28]. The WHO road map for access to medicines, vaccines and other health products, 2019-2023, aligns with the outputs that have been identified within the WHO framework including provision of authoritative guidance and standards on the quality, safety and efficacy of health products, access to essential medicines, vaccines, diagnostics and devices for PHC [29].…”