Economic evaluation of vaccination: capturing the full benefits, with an application to human papillomavirus

Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA  Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa.
Clinical Microbiology and Infection (Impact Factor: 5.2). 07/2012; 18 Suppl 5:70-6. DOI: 10.1111/j.1469-0691.2012.03977.x
Source: PubMed

ABSTRACT Clin Microbiol Infect 2012; 18 (Suppl. 5): 70-76 ABSTRACT: Vaccination has been among the greatest contributors to the past century's dramatic improvements in health and life expectancy. Recent advances in vaccinology have resulted in new vaccines that will likely lead to substantial future health gains. However, the high cost of these new vaccines, such as the human papillomavirus (HPV) vaccine, poses an obstacle to their widespread adoption in many countries. Economic evaluation can help to determine if investment in vaccine introduction is worthwhile. However, existing economic evaluations usually focus on a narrow set of vaccination-mediated benefits-most notably avoided medical-care costs-and fail to account for several categories of potentially important gains. We consider three sources of such benefit and discuss them with respect to HPV vaccination: (i) outcome-related productivity gains, (ii) behaviour-related productivity gains, and (iii) externalities. We also highlight that HPV vaccination protects against more than just cervical cancer and that these other health gains should be taken into account. Failing to account for these broader benefits of HPV vaccination could result in substantial underestimation of the value of HPV vaccination, thereby leading to ill-founded decisions regarding its introduction into national immunization programmes.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Vaccination has led to remarkable health gains over the last century. However, large coverage gaps remain, which will require significant financial resources and political will to address. In recent years, a compelling line of inquiry has established the economic benefits of health, at both the individual and aggregate levels. Most existing economic evaluations of particular health interventions fail to account for this new research, leading to potentially sizable undervaluation of those interventions. In line with this new research, we set forth a framework for conceptualizing the full benefits of vaccination, including avoided medical care costs, outcome-related productivity gains, behavior-related productivity gains, community health externalities, community economic externalities, and the value of risk reduction and pure health gains. We also review literature highlighting the magnitude of these sources of benefit for different vaccinations. Finally, we outline the steps that need to be taken to implement a broad-approach economic evaluation and discuss the implications of this work for research, policy, and resource allocation for vaccine development and delivery.
    Proceedings of the National Academy of Sciences 08/2014; 111(34). DOI:10.1073/pnas.1400475111 · 9.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This review focuses on selected challenges and opportunities concerning broader valuation of vaccines and immunization. The challenges involve conceptualizing and measuring the value of vaccines, while the opportunities relate to the strategic and systematic use of that information in health policy decisions that range from the adoption of particular vaccines in national immunization plans to the allocation of resources to vaccine research, development, and delivery. Clarifying the demonstrable individual, family, and community-level benefits of vaccines will allow the public health community to make better-informed and more meaningful comparisons of the costs of vaccines in relation to their full benefits. Taking advantage of this opportunity will require enhanced data collection and the development of strategic planning tools for transparently assessing trade-offs among the myriad attributes of different vaccines in various social and economic contexts. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Vaccine 06/2015; 33. DOI:10.1016/j.vaccine.2015.02.071 · 3.49 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Current evaluation models for the value of vaccines typically account for a small subset of the full social and economic benefits of vaccination. Health investments yield positive economic benefits via several channels at the household, community, and national levels. Underestimating, or worse, not considering these benefits can lead to ill-founded recommendations regarding the introduction of vaccines into immunization programs. The clear and strong links between health and wealth suggest the need to redesign valuation frameworks for vaccination so that the full costs may be properly weighed against the full benefits of vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Vaccine 06/2015; 33. DOI:10.1016/j.vaccine.2015.03.023 · 3.49 Impact Factor