Stakeholders’ perception on including broader economic impact of vaccines in economic evaluations in low and middle income countries: a mixed methods study

BMC Public Health

Research Article

Silvia MAA Evers¹  Ingeborg M van der Putten²  Rohan Deogaonkar³  Mark Jit⁴  Raymond CW Hutubessy⁵ 

[1] CAPHRI, School of Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands;CAPHRI, School of Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands;Initiative for Vaccine Research, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Geneva, Switzerland;Health Economics Unit, University of Birmingham, Birmingham, UK;Health Economics Unit, University of Birmingham, Birmingham, UK;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Initiative for Vaccine Research, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Geneva, Switzerland;

关键词: Mixed methods;    Economic evaluations;    Externalities;    Vaccines;    Immunization;    Decision making;    Low and middle income countries;    Developing countries;   

DOI  :  10.1186/s12889-015-1638-0

 received in 2014-05-21, accepted in 2015-03-15,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundCurrent health economic evaluation guidelines mainly concentrate on immediate health gains and cost savings for the individual involved in the intervention. However, it has been argued that these guidelines are too narrow to capture the full impact of vaccination in low and middle income countries. The inclusion of broader economic impact of vaccines (BEIV) has therefore been proposed. Some examples of these are productivity-related gains, macro-economic impact, and different externalities. Despite their potency, the extent to which such benefits can and should be incorporated into economic evaluations of vaccination is still unclear. This mixed methods study aims to assess the relevance of BEIV to different stakeholders involved in the vaccine introduction decision making process.MethodsIn this mixed method study an internet based survey was sent to attendees of the New and Underutilized Vaccines Initiative meeting in Montreux, Switzerland in 2011. Additionally, semi-structured interviews of 15 minutes each were conducted during the meeting. Study participants included decision makers, experts and funders of vaccines and immunization programs in low and middle income countries. Descriptive analysis of the survey, along with identification of common themes and factors extracted from the interviews and open survey questions was undertaken.ResultsEvidence on macro-economic impact, burden of disease and ecological effects were perceived as being most valuable towards aiding decision making for vaccine introduction by the 26 survey respondents. The 14 interviewees highlighted the importance of burden of disease and different types of indirect effects. Furthermore, some new interpretations of BEIVs were discussed, such as the potential negative impact of wastage during immunization programs and the idea of using vaccines as a platform for delivering other types of health interventions. Interviewees also highlighted the importance of using a broader perspective in connection to measuring economic impacts, particularly when attempting to derive the value of newer, more expensive vaccines.ConclusionAccording to participants, BEIVs were seen as being equally important as traditional outcome measures used in cost-effectiveness analyses. Such insight can be used to shape research agendas within this field and to eventually create broader, more inclusive practical guidelines for economic evaluations of vaccines.

【 授权许可】

Unknown   
© van der Putten et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.