title: Assessing the economic benefits of vaccines based on the health investment life course framework: a review of a broader approach to evaluate malaria vaccination.
abstract: BACKGROUND
  Economic evaluations have routinely understated the net benefits of vaccination by not including the full range of economic benefits that accrue over the lifetime of a vaccinated person. Broader approaches for evaluating benefits of vaccination can be used to more accurately calculate the value of vaccination.
  
  
  METHODS
  This paper reflects on the methodology of one such approach - the health investment life course approach - that looks at the impact of vaccine investment on lifetime returns. The role of this approach on vaccine decision-making will be assessed using the malaria health investment life course model example.
  
  
  RESULTS
  We describe a framework that measures the impact of a health policy decision on government accounts over many generations. The methodological issues emerging from this approach are illustrated with an example from a recently completed health investment life course analysis of malaria vaccination in Ghana. Beyond the results, various conceptual and practical challenges of applying this framework to Ghana are discussed in this paper.
  
  
  CONCLUSIONS
  The current framework seeks to understand how disease and available technologies can impact a range of economic parameters such as labour force participation, education, healthcare consumption, productivity, wages or economic growth, and taxation following their introduction. The framework is unique amongst previous economic models in malaria because it considers future tax revenue for governments. The framework is complementary to cost-effectiveness and budget impact analysis. The intent of this paper is to stimulate discussion on how existing and new methodology can add to knowledge regarding the benefits from investing in new and underutilized vaccines.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 855 N Wolfe St, Suite 600, Baltimore, MD 21205, United States. Electronic address: dconste1@jhu.edu.
authors.forename: Dagna
authors.initials: D
authors.lastname: Constenla
mesh_terms: D003362:Cost-Benefit Analysis; D005869:Ghana; D006262:Health / Q000191:economics*; D006291:Health Policy / Q000191:economics; D006801:Humans; D008288:Malaria / Q000517:prevention & control; D017780:Malaria Vaccines / Q000191:economics*; D018803:Models, Economic; D014611:Vaccination / Q000191:economics*
chemical_list: D017780:Malaria Vaccines
keywords: Broad economic evaluation; Ghana; Health investment life course approach; Malaria; Methodology; Review; Vaccine impact