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New Framework Enhances Evaluation of Vaccination Benefits in Health Technology Assessment

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A groundbreaking paper has emerged, presenting innovative methods for evaluating the multifaceted benefits of vaccinations within health technology assessment (HTA) and cost-effectiveness analysis (CEA). This final installment in a series introduces a comprehensive framework to assist decision-makers in recognizing the extensive advantages of vaccination programs, specifically focusing on health systems strengthening (HSS), equity, and macroeconomic gains. By employing expert working groups, targeted literature reviews, and illustrative case studies, the study offers a well-rounded approach for a more accurate and holistic value of vaccination (VoV) assessments.

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Health Systems Strengthening and Equity Benefits

The report utilizes opportunity cost methods to evaluate the HSS benefits of rotavirus vaccination. These benefits significantly reduce the incremental cost-effectiveness ratio (ICER) by a range of 1.4-50.5%, situating it between GBP 11,552 and GBP 23,016, depending on the scenarios considered. This reduction provides a compelling argument for incorporating HSS benefits in HTA/CEA, thereby enhancing market access for rotavirus vaccines.

Additionally, the study employs distributional CEA to address health equity benefits, particularly in meningococcal vaccination. The findings reveal that nearly 80% of avoided cases occur among the three most deprived groups, which leads to a reduction in ICER by 22-56%, bringing it down to GBP 7014-GBP 12,460. This approach underscores the importance of equity considerations in HTA/CEA, offering a pathway to improved market access for vaccines targeting underserved populations.

Macroeconomic Gains

The paper also explores the macroeconomic implications of vaccination, suggesting that these models can inform HTA deliberations by considering the broader economic impact, such as effects on the labor force and overall economy. Moreover, macroeconomic outcomes can be assessed for individuals in CEAs, factoring in non-health consumption, leisure time, and income. This holistic view can further facilitate market access by demonstrating the broader societal value of vaccination programs.

Concrete Findings

  • Rotavirus vaccination’s HSS benefits can reduce ICER by up to 50.5%, enhancing market access.
  • Incorporating equity benefits in meningococcal vaccination can decrease ICER by up to 56%, promoting vaccinations in deprived groups.
  • Macroeconomic models inform HTA by evaluating broader economic impacts, supporting market access through comprehensive benefits assessment.

The case studies presented in the paper provide actionable insights for integrating broader vaccination benefits into current HTA/CEA frameworks. Decision-makers are equipped with methods to conduct more comprehensive VoV assessments, which could revolutionize the way vaccinations are evaluated and adopted.

Nonetheless, further research is necessary to refine input data and methodologies, particularly concerning macroeconomic gains, to ensure the robustness of future assessments.

Original Article: Vaccines (Basel). 2024 Jul 15;12(7):773. doi: 10.3390/vaccines12070773.

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