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Vaccines
Special Issues
Health Economics of Vaccines
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Health Economics of Vaccines

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 35629

Special Issue Editors

Prof. Dr. Maarten J. Postma

E-Mail Website
Guest Editor
1. Department of Health Sciences, University Medical Centre Groningen, University of Groningen, NL 9713 GZ Groningen, The Netherlands
2. Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, NL 9713 GZ Groningen, The Netherlands
Interests: vaccines; global health; health technology assessment; cost-effectiveness; health economics
Special Issues, Collections and Topics in MDPI journals
Dr. Cornelis Boersma

E-Mail Website1 Website2
Guest Editor
Division of Global Health, Department of Health Sciences, University Medical Center, University of Groningen, The Netherlands
Interests: health economics; health policy; health outcomes; epidemiology; prevention; health systems
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Health economic analysis of vaccines is increasing in importance. In many jurisdictions, cost-effectiveness plays an important role in the final decision to include a vaccine into the National Immunization Programma. The UK’s Joint Committee of Vaccination & Immunization may serve as an example here. It is often argued that cost-effectiveness for vaccines typically differs from that for curative drugs with specificities in the areas of broader economic impacts, indirect effects, spill-overs, timing of benefits and evidence requirements. This special issue aims to provide an overview of these aspects from both theoretical as well as practical (illustrations) angles.

Prof. Dr. Maarten J. Postma

Dr. Cornelis Boersma

Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vaccines
  • Cost-effectiveness
  • Health economics
  • Economic impact
  • Economic modelling

Published Papers (7 papers)

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Research

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14 pages, 473 KiB  
Article
Rotavirus Vaccination of Infants Delayed and Limited within the National Immunization Programme in the Netherlands: An Opportunity Lost
by Florian Zeevat, Evgeni Dvortsin, Abrham Wondimu, Jan C. Wilschut, Cornelis Boersma and Maarten J. Postma
Vaccines 2021, 9(2), 144; https://doi.org/10.3390/vaccines9020144 - 10 Feb 2021
Cited by 3 | Viewed by 2037
Abstract
In this study, we estimated the benefits of rotavirus vaccination for infants had the rotavirus vaccine been introduced in the Netherlands as of its market authorization in 2006. An age-structured, deterministic cohort model was developed to simulate different birth cohorts over a period [...] Read more.
In this study, we estimated the benefits of rotavirus vaccination for infants had the rotavirus vaccine been introduced in the Netherlands as of its market authorization in 2006. An age-structured, deterministic cohort model was developed to simulate different birth cohorts over a period of 15 years from 2006 until 2021, comparing both universal and targeted high-risk group vaccination to no vaccination. Different scenarios for the duration of protection (5 or 7 years) and herd immunity (only for universal vaccination) were analyzed. All birth cohorts together included 2.6 million infants, of which 7.9% were high-risk individuals, and an additional 13.2 million children between 1–15 years born prior to the first cohort in 2006. The costs and health outcomes associated with rotavirus vaccination were calculated per model scenario and discounted at 4% and 1.5%, respectively. Our analysis reveals that, had rotavirus vaccination been implemented in 2006, it would have prevented 356,800 (51% decrease) and 32,200 (5% decrease) cases of rotavirus gastroenteritis after universal and targeted vaccination, respectively. Over the last 15 years, this would have led to significant avoided costs and quality-adjusted life year losses for either vaccination strategy with the most favorable outcomes for universal vaccination. Clearly, an opportunity has been lost. Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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18 pages, 2179 KiB  
Article
Clinical and Economic Outcomes Associated with Cell-Based Quadrivalent Influenza Vaccine vs. Standard-Dose Egg-Based Quadrivalent Influenza Vaccines during the 2018–19 Influenza Season in the United States
by Girishanthy Krishnarajah, Victoria Divino, Maarten J. Postma, Stephen I. Pelton, Vamshi Ruthwik Anupindi, Mitch DeKoven and Joaquin Mould-Quevedo
Vaccines 2021, 9(2), 80; https://doi.org/10.3390/vaccines9020080 - 23 Jan 2021
Cited by 12 | Viewed by 4408
Abstract
Non-egg-based influenza vaccines eliminate the potential for egg-adapted mutations and potentially increase vaccine effectiveness. This retrospective study compared hospitalizations/emergency room (ER) visits and all-cause annualized healthcare costs among subjects aged 4–64 years who received cell-based quadrivalent (QIVc) or standard-dose egg-based quadrivalent (QIVe-SD) influenza [...] Read more.
Non-egg-based influenza vaccines eliminate the potential for egg-adapted mutations and potentially increase vaccine effectiveness. This retrospective study compared hospitalizations/emergency room (ER) visits and all-cause annualized healthcare costs among subjects aged 4–64 years who received cell-based quadrivalent (QIVc) or standard-dose egg-based quadrivalent (QIVe-SD) influenza vaccine during the 2018–19 influenza season. Administrative claims data (IQVIA PharMetrics® Plus, IQVIA, USA) were utilized to evaluate clinical and economic outcomes. Adjusted relative vaccine effectiveness (rVE) of QIVc vs. QIVe-SD among overall cohort, as well as for three subgroups (age 4–17 years, age 18–64 years, and high-risk) was evaluated using inverse probability of treatment weighting (IPTW) and Poisson regression models. Generalized estimating equation models among the propensity score matched sample were used to estimate annualized all-cause costs. A total of 669,030 recipients of QIVc and 3,062,797 of QIVe-SD were identified after IPTW adjustments. Among the overall cohort, QIVc had higher adjusted rVEs against hospitalizations/ER visits related to influenza, all-cause hospitalizations, and hospitalizations/ER visits associated with any respiratory event compared to QIVe-SD. The adjusted annualized all-cause total costs were higher for QIVe-SD compared to QIVc ((+$461); p < 0.05). Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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14 pages, 2051 KiB  
Article
Cost-Effectiveness Analysis of BCG Vaccination against Tuberculosis in Indonesia: A Model-Based Study
by Afifah Machlaurin, Franklin Christiaan Karel Dolk, Didik Setiawan, Tjipke Sytse van der Werf and Maarten J. Postma
Vaccines 2020, 8(4), 707; https://doi.org/10.3390/vaccines8040707 - 26 Nov 2020
Cited by 6 | Viewed by 4370
Abstract
Bacillus Calmette–Guerin (BCG), the only available vaccine for tuberculosis (TB), has been applied for decades. The Indonesian government recently introduced a national TB disease control programme that includes several action plans, notably enhanced vaccination coverage, which can be strengthened through underpinning its favourable [...] Read more.
Bacillus Calmette–Guerin (BCG), the only available vaccine for tuberculosis (TB), has been applied for decades. The Indonesian government recently introduced a national TB disease control programme that includes several action plans, notably enhanced vaccination coverage, which can be strengthened through underpinning its favourable cost-effectiveness. We designed a Markov model to assess the cost-effectiveness of Indonesia’s current BCG vaccination programme. Incremental cost-effectiveness ratios (ICERs) were evaluated from the perspectives of both society and healthcare. The robustness of the analysis was confirmed through univariate and probabilistic sensitivity analysis (PSA). Using epidemiological data compiled for Indonesia, BCG vaccination at a price US$14 was estimated to be a cost-effective strategy in controlling TB disease. From societal and healthcare perspectives, ICERs were US$104 and US$112 per quality-adjusted life years (QALYs), respectively. The results were robust for variations of most variables in the univariate analysis. Notably, the vaccine’s effectiveness regarding disease protection, vaccination costs, and case detection rates were key drivers for cost-effectiveness. The PSA results indicated that vaccination was cost-effective even at US$175 threshold in 95% of cases, approximating the monthly GDP per capita. Our findings suggest that this strategy was highly cost-effective and merits prioritization and extension within the national TB programme. Our results may be relevant for other high endemic low- and middle-income countries. Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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16 pages, 780 KiB  
Article
Value Frameworks for Vaccines: Which Dimensions Are Most Relevant?
by Jeroen Luyten, Roselinde Kessels, Corinne Vandermeulen and Philippe Beutels
Vaccines 2020, 8(4), 628; https://doi.org/10.3390/vaccines8040628 - 28 Oct 2020
Cited by 4 | Viewed by 2404
Abstract
In addition to more narrow criteria such as safety, effectiveness and cost-effectiveness, vaccines can also be evaluated based on broader criteria such as their economic impact, contribution to disease eradication objectives, caregiver aspects, financial protection offered, equity or social acceptability. We summarize a [...] Read more.
In addition to more narrow criteria such as safety, effectiveness and cost-effectiveness, vaccines can also be evaluated based on broader criteria such as their economic impact, contribution to disease eradication objectives, caregiver aspects, financial protection offered, equity or social acceptability. We summarize a survey executed in a sample of the population (n = 1000) in Flanders, Belgium, in which we investigated support for using these broader criteria to evaluate vaccines for funding decisions. By means of both favourable and unfavourable framings of a hypothetical vaccine across 40 value dimensions, we find support for the view that people indeed consider a broad range of medical and socio-economic criteria relevant. Several of these are not incorporated in standard evaluation frameworks for vaccines. The different results we find for different framings highlight the importance of developing a consistent a priori value framework for vaccine evaluation, rather than evaluating vaccines on an ad hoc basis. Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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Review

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28 pages, 3171 KiB  
Review
Inclusion of Safety-Related Issues in Economic Evaluations for Seasonal Influenza Vaccines: A Systematic Review
by Tanja Fens, Pieter T. de Boer, Eugène P. van Puijenbroek and Maarten J. Postma
Vaccines 2021, 9(2), 111; https://doi.org/10.3390/vaccines9020111 - 02 Feb 2021
Cited by 4 | Viewed by 3355
Abstract
(1) Background: Vaccines for seasonal influenza are a good preventive and cost-effective strategy. However, it is unknown if and how these economic evaluations include the adverse events following immunization (AEFI), and what the impact of such inclusion is on the health economic outcomes. [...] Read more.
(1) Background: Vaccines for seasonal influenza are a good preventive and cost-effective strategy. However, it is unknown if and how these economic evaluations include the adverse events following immunization (AEFI), and what the impact of such inclusion is on the health economic outcomes. (2) Methods: We searched the literature, up to January 2020, to identify economic evaluations of seasonal influenza vaccines that considered AEFIs. The review protocol was published in PROSPERO (CDR42017058523). (3) Results: A total of 52 economic evaluations considered AEFI-related parameters in their analyses, reflecting 16% of the economic evaluations on seasonal influenza vaccines in the initial study selection. Most studies used the societal perspective (64%) and evaluated vaccination of children (37%). Where considered, studies included direct medical costs of AEFIs (90%), indirect costs (27%), and disutilities/quality-adjusted life years loss due to AEFIs (37%). The majority of these studies accounted for the effects of the costs of AEFI on cost-effectiveness for Guillain–Barré syndrome. In those papers allowing cost share estimation, direct medical cost of AFEIs was less than 2% of total direct costs. (4) Conclusions: Although the overall impact of AEFIs on the cost-effectiveness outcomes was found to be low, we urge their inclusion in economic evaluations of seasonal influenza vaccines to reflect comprehensive reports for the decision makers and end-users of the vaccination strategies. Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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Other

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10 pages, 528 KiB  
Viewpoint
COVID-19 Vaccine Roll-Out in South Africa and Zimbabwe: Urgent Need to Address Community Preparedness, Fears and Hesitancy
by Tafadzwa Dzinamarira, Brian Nachipo, Bright Phiri and Godfrey Musuka
Vaccines 2021, 9(3), 250; https://doi.org/10.3390/vaccines9030250 - 12 Mar 2021
Cited by 103 | Viewed by 14888
Abstract
South Africa became one of the first African countries to receive the COVID-19 vaccine. As the rest of Africa prepares to receive COVID-19 vaccines, most countries in Africa have set up national-level coordination committees for developing national vaccination deployment plans. While the main [...] Read more.
South Africa became one of the first African countries to receive the COVID-19 vaccine. As the rest of Africa prepares to receive COVID-19 vaccines, most countries in Africa have set up national-level coordination committees for developing national vaccination deployment plans. While the main focus of these committees has been on setting up strategies that facilitate the swift distribution of COVID-19 vaccines once they are available, the role of effective public health awareness should not be ignored. Countries must devise strategies on how best to enhance public understanding and curb misinformation about the vaccines. With this viewpoint, we unpack the threat of COVID-19 vaccine hesitancy and offer recommendations for COVID-19 vaccine communication strategies in the South African and Zimbabwean contexts. Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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11 pages, 222 KiB  
Concept Paper
Estimating the Fiscal Consequences of National Immunization Programs Using a “Government Perspective” Public Economic Framework
by Mark P. Connolly and Nikolaos Kotsopoulos
Vaccines 2020, 8(3), 495; https://doi.org/10.3390/vaccines8030495 - 02 Sep 2020
Cited by 5 | Viewed by 2395
Abstract
Infectious diseases can impose considerable mortality and morbidity for children and adult populations resulting in both short- and long-term fiscal costs for government. Traditionally, healthcare costs are the dominant consideration in economic evaluations of vaccines, which likely ignores many costs that fall on [...] Read more.
Infectious diseases can impose considerable mortality and morbidity for children and adult populations resulting in both short- and long-term fiscal costs for government. Traditionally, healthcare costs are the dominant consideration in economic evaluations of vaccines, which likely ignores many costs that fall on governments in relation to vaccine-preventable conditions. In recent years, fiscal health modeling has been proposed as a complementary approach to cost-effectiveness analysis for considering the broader consequences for governments attributed to vaccines. Fiscal modeling evaluates public health investments attributed to treatments or preventive interventions in the case of vaccination, and how these investments influence government public accounts. This involves translating morbidity and mortality outcomes that can lead to disability, associated costs, early retirement due to poor health, and death, which can result in lost tax revenue for government attributed to reduced lifetime productivity. To assess fiscal consequences of public health programs, discounted cash flow analysis can be used to translate how changes in morbidity and mortality influence transfer payments and changes in lifetime taxes paid based on initial health program investments. The aim of this review is to describe the fiscal health modeling framework in the context of vaccines and demonstrate key features of this approach and the role that public economic assessment of vaccines can make in understanding the broader economic consequences of investing in vaccination programs. In this review, we describe the theoretical foundations for fiscal modeling, the aims of fiscal model, the analytical outputs, and discuss the relevance of this framework for evaluating the economics of vaccines. Full article
(This article belongs to the Special Issue Health Economics of Vaccines)
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