title: Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?
abstract: Economic evaluation of vaccination is a key tool to inform effective spending on vaccines. However, many evaluations have been criticised for failing to capture features of vaccines which are relevant to decision makers. These include broader societal benefits (such as improved educational achievement, economic growth and political stability), reduced health disparities, medical innovation, reduced hospital beds pressures, greater peace of mind and synergies in economic benefits with non-vaccine interventions. Also, the fiscal implications of vaccination programmes are not always made explicit. Alternative methodological frameworks have been proposed to better capture these benefits. However, any broadening of the methodology for economic evaluation must also involve evaluations of non-vaccine interventions, and hence may not always benefit vaccines given a fixed health-care budget. The scope of an economic evaluation must consider the budget from which vaccines are funded, and the decision-maker's stated aims for that spending to achieve.
authors.affiliation: Modelling and Economics Unit, Public Health England, 61 Colindale Avenue, London, NW9 6BT, UK. mark.jit@phe.gov.uk.|Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. mark.jit@phe.gov.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Jit
authors.affiliation: Initiative for Vaccine Research, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland.
authors.forename: Raymond
authors.initials: R
authors.lastname: Hutubessy
mesh_terms: D003362:Cost-Benefit Analysis / Q000379:methods / Q000592:standards*; D003657:Decision Making; D019049:Developed Countries / Q000191:economics; D003906:Developing Countries / Q000191:economics; D000069576:Health Equity / Q000191:economics / Q000592:standards*; D006801:Humans; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D014612:Vaccines / Q000191:economics*
chemical_list: D014612:Vaccines
references.citation: Lancet. 2007 Feb 3;369(9559):389-96
references.pmid: 17276779
references.citation: Vaccine. 2015 Jul 31;33(32):3788-94
references.pmid: 26144897
references.citation: BMJ. 2014 Oct 09;349:g5725
references.pmid: 25301037
references.citation: Vaccine. 2015 Sep 11;33(38):5020-6
references.pmid: 25936663
references.citation: J Mark Access Health Policy. 2015 Aug 12;3:
references.pmid: 27123171
references.citation: BMJ. 2011 Sep 27;343:d5775
references.pmid: 21951758
references.citation: BMC Med. 2015 Sep 03;13:209
references.pmid: 26335923
references.citation: Public Health Genomics. 2009;12(5-6):343-51
references.pmid: 19684446
references.citation: Health Aff (Millwood). 2011 Jun;30(6):1010-20
references.pmid: 21653951
references.citation: Vaccine. 2012 Feb 27;30(10):1813-22
references.pmid: 22240341
references.citation: Vaccine. 2011 Mar 16;29(13):2371-80
references.pmid: 21159324
references.citation: PLoS One. 2015 May 05;10(5):e0125878
references.pmid: 25941805
references.citation: PLoS One. 2011;6(10):e26190
references.pmid: 22022559
references.citation: Pharmacoeconomics. 2011 May;29(5):371-86
references.pmid: 21504239
references.citation: Cost Eff Resour Alloc. 2014 Jan 22;12(1):3
references.pmid: 24450591
references.citation: Lancet Infect Dis. 2008 Nov;8(11):727-33
references.pmid: 18992409
references.citation: Science. 2015 May 8;348(6235):694-9
references.pmid: 25954009
references.citation: Vaccine. 2013 Nov 4;31(46):5392-7
references.pmid: 24075918
references.citation: Med Decis Making. 2009 Jan-Feb;29(1):33-50
references.pmid: 18948433
references.citation: Expert Rev Vaccines. 2008 Aug;7(6):753-82
references.pmid: 18665775
references.citation: Vaccine. 2014 Feb 7;32(7):759-65
references.pmid: 24295806
references.citation: Vaccine. 2010 Apr 19;28 Suppl 1:A1-5
references.pmid: 20412988
references.citation: Vaccine. 2009 Oct 19;27(44):6121-8
references.pmid: 19715781
references.citation: Expert Rev Pharmacoecon Outcomes Res. 2009 Aug;9(4):333-46
references.pmid: 19670994
references.citation: Vaccine. 2010 Feb 17;28(7):1702-8
references.pmid: 20044060
references.citation: Vaccine. 2014 Sep 3;32(39):5065-70
references.pmid: 25045822
references.citation: BMC Public Health. 2010 May 14;10:253
references.pmid: 20470426
references.citation: Vaccine. 2015 Mar 30;33(14):1633-58
references.pmid: 25681663
references.citation: Sex Health. 2010 Sep;7(3):352-8
references.pmid: 20719227
references.citation: Vaccine. 2007 Feb 9;25(8):1355-67
references.pmid: 17208339
references.citation: Pharmacoeconomics. 2012 Apr;30(4):337-53
references.pmid: 22409292
references.citation: Vaccine. 2013 Aug 20;31(37):3786-804
references.pmid: 23830973
references.citation: Hum Vaccin Immunother. 2013 Jun;9(6):1272-88
references.pmid: 23571226
references.citation: Pharmacoeconomics. 2014 Jan;32(1):29-45
references.pmid: 24288207
references.citation: BMJ. 2004 Nov 20;329(7476):1233-6
references.pmid: 15550430
references.citation: Bull World Health Organ. 2010 Jun;88(6):402
references.pmid: 20539847
references.citation: Clin Drug Investig. 2015 Aug;35(8):471-85
references.pmid: 26187455
references.citation: MMWR Morb Mortal Wkly Rep. 2014 Apr 25;63(16):352-5
references.pmid: 24759657
references.citation: Lancet Glob Health. 2014 May;2(5):e251-2
references.pmid: 25103158
references.citation: BMJ. 1999 Apr 24;318(7191):1136
references.pmid: 10213735
references.citation: Pharmacoeconomics. 2008;26(3):191-215
references.pmid: 18282015
references.citation: Lancet Glob Health. 2014 Jul;2(7):e406-14
references.pmid: 25103394
references.citation: JAMA. 1996 Oct 16;276(15):1253-8
references.pmid: 8849754
references.citation: BMC Health Serv Res. 2010 Jul 02;10 Suppl 1:S5
references.pmid: 20594371
references.citation: Arch Dis Child. 2015 Jun;100(6):514-6
references.pmid: 25670403
references.citation: Expert Rev Vaccines. 2003 Oct;2(5):649-60
references.pmid: 14711326
references.citation: Lancet. 2013 Dec 7;382(9908):1898-955
references.pmid: 24309475
references.citation: Proc Natl Acad Sci U S A. 2015 Mar 10;112(10):3014-9
references.pmid: 25605894
references.citation: Clin Microbiol Infect. 2012 Oct;18 Suppl 5:70-6
references.pmid: 22882176
references.citation: Vaccine. 2013 Oct 1;31(42):4902-10
references.pmid: 23871824