title: Results from evaluations of models and cost-effectiveness tools to support introduction decisions for new vaccines need critical appraisal.
abstract: The World Health Organization (WHO) recommends that the cost-effectiveness (CE) of introducing new vaccines be considered before such a programme is implemented. However, in low- and middle-income countries (LMICs), it is often challenging to perform and interpret the results of model-based economic appraisals of vaccines that benefit from locally relevant data. As a result, WHO embarked on a series of consultations to assess economic analytical tools to support vaccine introduction decisions for pneumococcal, rotavirus and human papillomavirus vaccines. The objectives of these assessments are to provide decision makers with a menu of existing CE tools for vaccines and their characteristics rather than to endorse the use of a single tool. The outcome will provide policy makers in LMICs with information about the feasibility of applying these models to inform their own decision making. We argue that if models and CE analyses are used to inform decisions, they ought to be critically appraised beforehand, including a transparent evaluation of their structure, assumptions and data sources (in isolation or in comparison to similar tools), so that decision makers can use them while being fully aware of their robustness and limitations.
authors.affiliation: Initiative for Vaccine Research, Immunization, Biologicals and Vaccines Department, World Health Organization, 20 Avenue Appia, CH-1210 Geneva, Switzerland. hutubessyr@who.int
authors.forename: Raymond
authors.initials: R
authors.lastname: Hutubessy
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Henao
authors.forename: Pem
authors.initials: P
authors.lastname: Namgyal
authors.forename: Vasee
authors.initials: V
authors.lastname: Moorthy
authors.forename: Joachim
authors.initials: J
authors.lastname: Hombach
mesh_terms: D003362:Cost-Benefit Analysis / Q000379:methods / Q000592:standards; D005069:Evaluation Studies as Topic; D006801:Humans; D015233:Models, Statistical; D030361:Papillomavirus Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D012400:Rotavirus Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000191:economics* / Q000276:immunology*; D014611:Vaccination / Q000191:economics*
chemical_list: D022243:Rotavirus Vaccines