10 considerations for conducting health economic evaluations of vaccines

There are numerous methods for conducting health economic evaluation of vaccines, and it is helpful to understand the elements of each.

As a starting point, here are 10 considerations based on guidance1 from the National Immunization Technical Advisory Group (NITAG) and insights from our market access work with leading vaccine manufacturers.

  1. Systematic literature reviews are conducted by NITAGs to identify modeling inputs and published models – this is an opportunity for manufacturer data to be identified as model inputs, or manufacturer models to be picked up. 
     
  2. Clinical evidence is quality assessed by NITAGs using GRADE or local qualitystandards. 
     
  3. Herd immunity and resulting health benefits are an important factor to consider for economic evaluations of vaccines. 
     
  4. Dynamic transmission models are recommended when herd immunity should be considered. Germany and WHO provide detailed guidance on choice of dynamic vs static models. 
     
  5. Cost-utility analyses (CUAs) are recommended for economic analysis of vaccines in most countries. 
     
  6. Quality-adjusted life-years (QALYs) are recommended consistently as a benefit measure. 
     
  7. Indirect costs should be included for the societal perspective in Germany. Loss of productivity is excluded in France and the UK but can be presented separately. Indirect costs can also be considered in the US and by WHO. 
     
  8. Direct costs for inclusion in economic evaluations differ between markets and vaccines. 
     
  9. Extensive sensitivity analyses are important for all areas of uncertainty, in particular when input data are limited. For example: incidence of disease, fatality risks, vaccine effectiveness (where unknown or uncertain), coverage, duration of protection, compliance, utilization of vaccination boosters, target groups (e.g., age), contact patterns, herd effects, time horizon, vaccine price, discount rates, indirect costs. 
     
  10. Incremental cost-effectiveness ratios (ICERs) are consistently recommended as a summary measure; however, net benefit expressed in monetary or health units is also recommended in France and by WHO. 

To help you prepare for successful market access, this collection of case studies includes real-world examples and insights from health economic evaluations of vaccines.

1Collated June 2021.

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