title: Funding of drugs: do vaccines warrant a different approach?
abstract: Vaccines have features that require special consideration when assessing their cost-effectiveness. These features are related to herd immunity, quality-of-life losses in young children, parental care and work loss, time preference, uncertainty, eradication, macroeconomics, and tiered pricing. Advisory committees on public funding for vaccines, or for pharmaceuticals in general, should be knowledgable about these special features. We discuss key issues and difficulties in decision making for vaccines against rotavirus, human papillomavirus, varicella-zoster virus, influenza virus, and Streptococcus pneumoniae. We argue that guidelines for economic evaluation should be reconsidered generally to recommend (1) modelling options for the assessment of interventions against infectious diseases; (2) a wider perspective to account for impacts on third parties, if relevant; (3) a wider scope of costs than health-care system costs alone, if appropriate; and (4) alternative discounting techniques to explore social time preference over long periods.
authors.affiliation: Centre for Health Economics Research and Modelling Infectious Diseases, Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium. philippe.beutels@ua.ac.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
authors.forename: C Raina
authors.initials: CR
authors.lastname: MacIntyre
mesh_terms: D003362:Cost-Benefit Analysis; D055808:Drug Discovery / Q000191:economics*; D004345:Drug Industry / Q000191:economics; D006291:Health Policy / Q000191:economics*; D006801:Humans; D014765:Viral Vaccines / Q000191:economics*; D014777:Virus Diseases / Q000517:prevention & control*
chemical_list: D014765:Viral Vaccines