title: Post-GAVI sustainability of the Haemophilus influenzae type b vaccine program: The potential role of economic evaluation.
abstract: Haemophilus influenzae type b (Hib) can cause severe invasive diseases which are, however, preventable by vaccination. To increase access to Hib vaccine, GAVI - the Vaccine Alliance - has provided financial support for 73 lower income countries worldwide. At the same time, GAVI has been implementing its co-financing policy, requiring recipient countries to pay a portion of vaccine costs and to increase this amount over time. Starting in 2016, 5 countries will stop receiving GAVI funding and procure the vaccine themselves. Although the graduating countries have access to the UNICEF/GAVI tendered vaccine price for 5 more years, the uncertainty in market vaccine price may hamper the post-GAVI program sustainability. A possible increase in vaccine price would cause a significant burden on governmental budgets, discouraging countries to continue the program. As a special tool, economic evaluation (EE) can assist decision makers by identifying the maximum affordable vaccine price for countries to pay. Given that only 6 GAVI-eligible countries have such analyses published, more EEs are necessary to strengthen countries' commitment during this transition period. The information will also be useful for manufacturers to determine their pricing policy.
authors.affiliation: a Center for Value-based Care Research , Medicine Institute, Cleveland Clinic , Cleveland , OH , USA.
authors.forename: Phuc
authors.initials: P
authors.lastname: Le
authors.affiliation: b Department of Management , Policy and Community Health, The University of Texas School of Public Health , Houston , TX , USA.
authors.forename: Van T
authors.initials: VT
authors.lastname: Nghiem
authors.affiliation: b Department of Management , Policy and Community Health, The University of Texas School of Public Health , Houston , TX , USA.|c Center for Clinical Research and Evidence-Based Medicine , The University of Texas School of Medicine , Houston , TX , USA.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Swint
mesh_terms: D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006192:Haemophilus Infections / Q000382:microbiology / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D019741:Haemophilus influenzae type b / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn
chemical_list: D018073:Haemophilus Vaccines
keywords: GAVI; Haemophilus influenzae type b; economic evaluation; global health; vaccine