Methodological concerns with economic evaluations of meningococcal vaccines.
The evolution of meningococcal vaccines illustrates nicely the incremental technological process that is common to much medical innovation and particularly appropriate to economic analysis. However, the economic evaluation of vaccines is complicated by several features unique to vaccines, including the possibility of indirect (herd immunity) benefits and the shear breadth of vaccination strategies available to decision makers. As with the vaccines themselves, the modelling approaches applied to the economic evaluation of meningococcal vaccines have evolved to become increasingly complex. Despite such innovation, concerns remain about the quality of economic studies of meningococcal vaccines. This article reviews evaluations of meningococcal vaccine strategies in developed countries and provides recommendations for future work in this area. Four potentially problematic areas in the existing literature are identified - indirect costs, herd immunity, quality of life and comparison programmes - and approaches to these issues are discussed. Recommendations for reporting a 'minimum analysis profile' case are also made. Although comparisons across studies are difficult at best, recent work shows that incorporating the indirect benefits and costs of vaccination substantially improves cost effectiveness.
Kauf
Teresa L
TL
Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA. tkauf@ufl.edu
D003362:Cost-Benefit Analysis / Q000379:methods* / Q000592:standards*; D005069:Evaluation Studies as Topic; D017048:Health Care Costs; D006801:Humans; D032521:Immunity, Herd; D032541:Mass Vaccination / Q000191:economics*; D022401:Meningococcal Vaccines / Q000191:economics*; D018803:Models, Economic; D011788:Quality of Life
D022401:Meningococcal Vaccines
Vaccine. 2004 Dec 9;23(4):470-9
15530695
Arch Pediatr Adolesc Med. 2005 Dec;159(12):1136-44
16330737
Med Decis Making. 2006 Jan-Feb;26(1):38-47
16495199
JAMA. 1994 Feb 2;271(5):375-81
8283587
Pharmacoeconomics. 2007;25(2):143-54
17249856
Expert Rev Vaccines. 2006 Apr;5(2):269-75
16608426
CMAJ. 1992 Feb 15;146(4):473-81
1306034
Vaccine. 2001 Oct 12;20(1-2):202-7
11567765
BMJ. 2002 Apr 6;324(7341):809
11934772
Int J Epidemiol. 2001 Jun;30(3):571-8; discussion 578-9
11416085
Vaccine. 2005 Mar 18;23(17-18):2095-103
15755578
J Health Econ. 1995 Jun;14(2):171-89
10154656
Vaccine. 2003 Oct 1;21(27-30):4145-52
14505894
BMC Public Health. 2007 Jun 29;7:130
17603880
Vaccine. 2007 Jul 20;25(29):5433-40
17560695
Am J Public Health. 1995 Jun;85(6):843-5
7762722
Vaccine. 2004 Mar 12;22(9-10):1233-40
15003652
Can J Infect Dis. 2004 Jan;15(1):25-8
18159440
Pharmacoeconomics. 2003;21(6):429-42
12678569
J Health Econ. 2008 Mar;27(2):476-95
18179834
Am J Public Health. 1985 Jul;75(7):739-44
3923849
Vaccine. 2002 Jun 21;20(21-22):2840-4
12102036
Health Econ. 2002 Jul;11(5):415-30
12112491
Expert Rev Vaccines. 2003 Oct;2(5):649-60
14711326
Pharmacoeconomics. 2005;23(9):855-74
16153131
Clin Infect Dis. 2008 Jan 1;46(1):1-13
18171206
Pharmacoeconomics. 2006;24(2):141-53
16460135
Med Decis Making. 2000 Apr-Jun;20(2):207-15
10772358
Int J Technol Assess Health Care. 2004 Summer;20(3):280-8
15446757
Vaccine. 2007 Aug 10;25(32):5945-57
17629362
Expert Rev Vaccines. 2009 Jul;8(7):851-61
19538112
Soc Sci Med. 1993 Jul;37(1):33-40
8332922
Pharmacoeconomics. 2007;25(9):713-26
17803331
JAMA. 1984 Jun 15;251(23):3109-13
6427489
Pediatrics. 2005 May;115(5):1220-32
15867028
Am J Prev Med. 2002 Aug;23(2):98-105
12121797
Health Technol Assess. 1999;3(2):1-134
10448202
Clin Infect Dis. 2002 Aug 1;35(3):294-7
12115095
Hum Vaccin. 2006 Mar-Apr;2(2):68-73
17012888
Clin Ther. 2003 Oct;25(10):2614-30
14667962