Vaccines and Health Economics

Dear Colleagues,

Correctly defining the health economics of new vaccines at market launch by which a value price is determined is a challenging endeavour from the perspective of the payer and the producer: too much or not enough? The reason that these difficulties may appear is that a known evaluation scheme of cost-effectiveness is applied as a copy/paste exercise of what is executed for treatment drugs. The question often raised is whether this is the right approach for vaccines. Vaccines should be positioned as preventative, public health measures that essentially gain the maximum benefit at the population or societal level when the vaccination is sustained to control infection spread leading to disease. The consequences of good vaccination programmes, short to long term, are that, with the prevention they engender, QALY-loss reduction is achieved as a clinical outcome. However, major additional societal gains should be considered as well, such as a safe environment, decreased use of expensive healthcare, better work conditions, more familial rest, and increased taxation gains. Those different elements could be observed, but they are often not included in the value assessment because they are not measured. Should those gains be considered in the price setting of the vaccine as we do for treatment drugs? Potentially not, as those total value assessments could then become unpayable. However, they should be measured because they provide decision-makers with better arguments about the societal values needed to give support to vaccination. The health economics of vaccines should therefore enrich and position its evaluation with necessary societal gains of real-world data to overcome potential hesitancy without being the driver of price setting. 

Prof. Dr. Baudouin Standaert
Guest Editor

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