title: Using cost-effectiveness analysis to support research and development portfolio prioritization for product innovations in measles vaccination.
abstract: BACKGROUND
  Several potential measles vaccine innovations are in development to address the shortcomings of the current vaccine. Funders need to prioritize their scarce research and development resources. This article demonstrates the usefulness of cost-effectiveness analysis to support these decisions.
  
  
  METHODS
  This study had 4 major components: (1) identifying potential innovations, (2) developing transmission models to assess mortality and morbidity impacts, (3) estimating the unit cost impacts, and (4) assessing aggregate cost-effectiveness in United Nations Children's Fund countries through 2049.
  
  
  RESULTS
  Four promising technologies were evaluated: aerosol delivery, needle-free injection, inhalable dry powder, and early administration DNA vaccine. They are projected to have a small absolute impact in terms of reducing the number of measles cases in most scenarios because of already improving vaccine coverage. Three are projected to reduce unit cost per dose by $0.024 to $0.170 and would improve overall cost-effectiveness. Each will require additional investments to reach the market. Over the next 40 years, the aggregate cost savings could be substantial, ranging from $98.4 million to $689.4 million.
  
  
  CONCLUSIONS
  Cost-effectiveness analysis can help to inform research and development portfolio prioritization decisions. Three new measles vaccination technologies under development hold promise to be cost-saving from a global perspective over the long-term, even after considering additional investment costs.
authors.affiliation: Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, WA 98195, USA. lgarrisn@uw.edu
authors.forename: Louis P
authors.initials: LP
authors.lastname: Garrison
authors.forename: Chris T
authors.initials: CT
authors.lastname: Bauch
authors.forename: Brian W
authors.initials: BW
authors.lastname: Bresnahan
authors.forename: Tom K
authors.initials: TK
authors.lastname: Hazlet
authors.forename: Srikanth
authors.initials: S
authors.lastname: Kadiyala
authors.forename: David L
authors.initials: DL
authors.lastname: Veenstra
mesh_terms: D003362:Cost-Benefit Analysis; D016503:Drug Delivery Systems / Q000191:economics*; D014943:Global Health; D006801:Humans; D008457:Measles / Q000401:mortality / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage* / Q000191:economics* / Q000592:standards; D018803:Models, Economic; D012106:Research / Q000458:organization & administration*; D014480:United Nations; D014611:Vaccination / Q000191:economics / Q000379:methods / Q000639:trends
chemical_list: D008458:Measles Vaccine