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Pharmacoeconomics. 2016 Mar;34(3):227-44. doi: 10.1007/s40273-015-0335-2.

Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks: A Consensus Framework from a European Vaccine Economics Community.

Author information

1
Department for Infectious Disease Epidemiology, Immunisation Unit, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany. UltschB@rki.de.
2
Bielefeld University, Bielefeld, Germany.
3
University of Antwerp, Antwerp, Belgium.
4
Steinbeis University Berlin (SHB), Berlin, Germany.
5
Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany.
6
Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
7
World Health Organization (WHO), Geneva, Switzerland.
8
London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
9
Public Health England (PHE), London, UK.
10
Centre for Infectious Disease Control (RIVM), Bilthoven, The Netherlands.
11
Ludwig Maximilians University (LMU), Munich, Germany.
12
University of Hannover, Hannover, Germany.
13
Institut de Veille Sanitaire (InVS), Saint-Maurice Cedex, France.
14
Federal Joint Committee (G-BA), Berlin, Germany.
15
University of Groningen, Groningen, The Netherlands.
16
National Institute for Health and Welfare (THL), Helsinki, Finland.
17
University for Health Sciences, Medical Informatics and Technology (UMIT), Hall in Tirol, Austria.
18
ONCOTYROL, Center for Personalized Cancer Medicine, Innsbruck, Austria.
19
University of Duisburg-Essen, Essen, Germany.
20
Department for Infectious Disease Epidemiology, Immunisation Unit, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany.

Abstract

BACKGROUND:

Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist, several immunization-specific aspects (e.g. indirect effects or discounting approach) are still a subject of debate within the scientific community.

OBJECTIVE:

The objective of this study was to develop a consensus framework for HEEs of vaccines to support the development of national guidelines in Europe.

METHODS:

A systematic literature review was conducted to identify prevailing issues related to HEEs of vaccines. Furthermore, European experts in the field of health economics and immunization decision making were nominated and asked to select relevant aspects for discussion. Based on this, a workshop was held with these experts. Aspects on 'mathematical modelling', 'health economics' and 'decision making' were debated in group-work sessions (GWS) to formulate recommendations and/or--if applicable--to state 'pros' and 'contras'.

RESULTS:

A total of 13 different aspects were identified for modelling and HEE: model selection, time horizon of models, natural disease history, measures of vaccine-induced protection, duration of vaccine-induced protection, indirect effects apart from herd protection, target population, model calibration and validation, handling uncertainty, discounting, health-related quality of life, cost components, and perspectives. For decision making, there were four aspects regarding the purpose and the integration of HEEs of vaccines in decision making as well as the variation of parameters within uncertainty analyses and the reporting of results from HEEs. For each aspect, background information and an expert consensus were formulated.

CONCLUSIONS:

There was consensus that when HEEs are used to prioritize healthcare funding, this should be done in a consistent way across all interventions, including vaccines. However, proper evaluation of vaccines implies using tools that are not commonly used for therapeutic drugs. Due to the complexity of and uncertainties around vaccination, transparency in the documentation of HEEs and during subsequent decision making is essential.

PMID:
26477039
PMCID:
PMC4766233
DOI:
10.1007/s40273-015-0335-2
[Indexed for MEDLINE]
Free PMC Article

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