Capturing the value of vaccination within health technology assessment and health economics: Literature review and novel conceptual framework.

BACKGROUND

Vaccination provides significant health gains to individuals and society and can potentially improve health equity, healthcare systems and national economies. Policy decisions, however, are rarely informed by comprehensive economic evaluations (EE) including vaccination's wide-ranging value. The objective of this analysis was to focus on health technology assessment systems to identify relevant value concepts in order to improve current EE of non-pandemic vaccines.

METHODS

Following a literature review, a novel Value of Vaccination (VoV) framework was developed with experts in vaccine EE from developed countries with established health technology assessment systems.

RESULTS

Forty-four studies presenting value frameworks or concepts applicable to vaccination were included. Eighteen unique value concepts relevant to EE were identified and defined. These were categorised within the VoV framework using three dimensions, moving from a narrow payer perspective to a more expansive and societal perspective. The dimensions were: (I) conventional payer perspective concepts (e.g., health gains in vaccinees, direct medical costs); (II) conventional societal perspective concepts (e.g., indirect health/economic gains to caregivers/households, productivity in vaccinees); and (III) novel societal concepts (e.g., financial risk protection, peace of mind, societal health gains, healthcare systems security, political stability, social equity and macroeconomic gains). While good quality evidence and methods are available to support concepts in Dimensions I and II, further work is needed to generate the required evidence for vaccination impact on Dimension III concepts.

CONCLUSIONS

The devastating effect on nations of the COVID-19 pandemic has helped to highlight the potential far-reaching benefits that many vaccination programmes can offer. This VoV framework is particularly relevant to policy decisions considering EE, and the potential future expansion of non-pandemic vaccination value considerations. The framework helps to understand and compare current value considerations across countries and payer versus societal perspectives. It provides decision-makers with a transparent and logical path to broaden consideration of VoV in EE.

Informations de copyright

Copyright © 2022 GlaxoSmithKline Biologicals S.A. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Eliana Biundo, Ekkehard Beck, Mark Doherty and Shazia Sheikh are employed by and hold shares in the GSK group of companies. Antonio J Garcia-Ruiz received funding from the GSK group of companies during the conduct of this study. He also received grants and/or consulting fees and/or honoraria from SanofiPasteur, UCB, CHIESTI, Official College of Physicians, Sociedade Galega de Neuroloxía, and regional government outside of this work. Terry Nolan was a member and co-chair of the advisory board related to this study and established by the GSK group of companies and was paid an honorarium for his input to it. He received consulting fees and/or honoraria from AstraZeneca, Merck, Seqirus, SanofiPasteur, the GSK group of companies. He also received personal payment for participation for other advisory boards not related to this study from Clover, Zeria and Serum Institute of India, and is expert in the Victorian State Government advisory group on COVID vaccine roll-out outside of this submitted work. His institution received grants from the GSK group of companies, SanofiPasteur, Janssen, Seqirus and Serum Institute of India outside of this work. David Salisbury was a member and co-chair of the Advisory Board for this study, established by the GSK group of companies, and was paid an honorarium for his input. He has received consulting fees and/or honoraria, unrelated to this study, from AstraZeneca, Clover, the GSK group of companies, Janssen, Pfizer, SanofiPasteur and Seqirus. Beata Smela declared her institution received funding from the GSK group of companies during the conduct of this study. Nancy Devlin, Jürgen Wasem, Mondher Toumi and Maarten Postma were all members of the Advisory Board for this study, established by the GSK group of companies, and were paid an honorarium for their input. All authors declare no other financial and non-financial relationships and activities.