Capturing the Value of Vaccination within Health Technology Assessment and Health Economics—Practical Considerations for Expanding Valuation by Including Key Concepts
Eliana Biundo,
Mariia Dronova,
Annie Chicoye,
Richard Cookson,
Nancy Devlin,
T. Mark Doherty,
Stephanie Garcia,
Antonio J. Garcia-Ruiz,
Louis P. Garrison,
Terry Nolan,
Maarten Postma,
David Salisbury,
Hiral Shah,
Shazia Sheikh,
Richard Smith,
Mondher Toumi,
Jurgen Wasem,
Ekkehard Beck
Affiliations
Eliana Biundo
GSK, Building W23, 20 Avenue Fleming, 1300 Wavre, Belgium
Mariia Dronova
Putnam PHMR, 30-701 Krakow, Poland
Annie Chicoye
AC Health Consulting, Sciences Po, 75007 Paris, France
Richard Cookson
Centre for Health Economics, University of York, York YO10 5DD, UK
Nancy Devlin
Health Economics Unit, Centre for Health Policy, University of Melbourne, Melbourne 3010, Australia
T. Mark Doherty
GSK, Building W23, 20 Avenue Fleming, 1300 Wavre, Belgium
Stephanie Garcia
GSK, Building W23, 20 Avenue Fleming, 1300 Wavre, Belgium
Antonio J. Garcia-Ruiz
Department of Pharmacology and Clinical Therapeutics, Faculty of Medicine, University of Malaga, 29071 Malaga, Spain
Louis P. Garrison
School of Pharmacy, University of Washington, Seattle, WA 98195, USA
Terry Nolan
Health Economics Unit, Centre for Health Policy, University of Melbourne, Melbourne 3010, Australia
Maarten Postma
Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9700 AB Groningen, The Netherlands
David Salisbury
Programme for Global Health, Royal Institute of International Affairs, Chatham House, London SW1Y 4LE, UK
Hiral Shah
GSK, Building W23, 20 Avenue Fleming, 1300 Wavre, Belgium
Shazia Sheikh
GSK, Building W23, 20 Avenue Fleming, 1300 Wavre, Belgium
Richard Smith
College of Medicine and Health, University of Exeter, Exeter EX1 2HZ, UK
Mondher Toumi
Creativ-Ceutical, 1724 Luxembourg, Luxembourg
Jurgen Wasem
Institute for Health Care Management and Research, University of Duisburg-Essen, 45127 Essen, Germany
Ekkehard Beck
GSK, Building W23, 20 Avenue Fleming, 1300 Wavre, Belgium
Following the development of a value of vaccination (VoV) framework for health technology assessment/cost-effectiveness analysis (HTA/CEA), and identification of three vaccination benefits for near-term inclusion in HTA/CEA, this final paper provides decision makers with methods and examples to consider benefits of health systems strengthening (HSS), equity, and macroeconomic gains. Expert working groups, targeted literature reviews, and case studies were used. Opportunity cost methods were applied for HSS benefits of rotavirus vaccination. Vaccination, with HSS benefits included, reduced the incremental cost-effectiveness ratio (ICER) by 1.4–50.5% (to GBP 11,552–GBP 23,016) depending on alternative conditions considered. Distributional CEA was applied for health equity benefits of meningococcal vaccination. Nearly 80% of prevented cases were among the three most deprived groups. Vaccination, with equity benefits included, reduced the ICER by 22–56% (to GBP 7014–GBP 12,460), depending on equity parameters. Macroeconomic models may inform HTA deliberative processes (e.g., disease impact on the labour force and the wider economy), or macroeconomic outcomes may be assessed for individuals in CEAs (e.g., impact on non-health consumption, leisure time, and income). These case studies show how to assess broader vaccination benefits in current HTA/CEA, providing decision makers with more accurate and complete VoV assessments. More work is needed to refine inputs and methods, especially for macroeconomic gains.
