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Towards a Broader Assessment of Value in Vaccines: The BRAVE Way Forward

Author

Listed:
  • Eleanor Bell

    (Office of Health Economics)

  • Margherita Neri

    (Office of Health Economics)

  • Lotte Steuten

    (Office of Health Economics
    City, University of London)

Abstract

Background The COVID-19 pandemic shows that the impact of effective vaccines can extend well beyond vaccinated individuals and healthcare systems. Yet, these broader value elements are not typically considered in Health Technology Assessment (HTA) which may underestimate vaccines’ broader value. Objectives This study aimed to (1) describe the gap between broader value elements identified in value frameworks for vaccines and those recognised in HTA of vaccines in nine developed markets, and (2) develop expert-informed, consensus-based recommendations on how hurdles for broader value recognition could be overcome. Methods We used a four-step modified Delphi method consisting of literature research (phase I, pearl-growing approach using PubMed Web of Science and Google covering the years 2000–2019), two consecutive phases of expert elicitation (phase II and III, including two email surveys and one virtual round table with 10 experts from 9 countries) and synthesis of recommendations (phase IV). Results Results show that about half of the broader value elements relevant to vaccines are not (consistently) considered in HTA processes of multiple higher-income countries. Experts identified five priority areas for broader value recognition, including considering (1) more comprehensive cost offsets within the health care system, (2) carer quality of life, (3) transmission value, (4) prevention of antimicrobial resistance and (5) macroeconomic effects. Conclusion To achieve a broader recognition of the value of vaccines, a three-pronged approach was recommended, focusing on (1) Evidence: proactively steering generation of high-quality evidence to quantify the broader value of vaccines to society; (2) Ability: leveraging and further developing existing methodological and analytic expertise to appropriately recognise the broad value of vaccines within HTA processes; (3) Willingness: Stimulating stakeholder engagement to change the status quo and move towards more transparent and comprehensive value assessment processes for vaccines globally.

Suggested Citation

  • Eleanor Bell & Margherita Neri & Lotte Steuten, 2022. "Towards a Broader Assessment of Value in Vaccines: The BRAVE Way Forward," Applied Health Economics and Health Policy, Springer, vol. 20(1), pages 105-117, January.
    • Handle: RePEc:spr:aphecp:v:20:y:2022:i:1:d:10.1007_s40258-021-00683-z
    DOI: 10.1007/s40258-021-00683-z
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    References listed on IDEAS

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    1. David E. Bloom & Michael Kuhn & Klaus Prettner, 2022. "Modern Infectious Diseases: Macroeconomic Impacts and Policy Responses," Journal of Economic Literature, American Economic Association, vol. 60(1), pages 85-131, March.
    2. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39, February.
    3. Mark Jit & Raymond Hutubessy, 2016. "Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?," Applied Health Economics and Health Policy, Springer, vol. 14(3), pages 245-252, June.
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    Cited by:

    1. Brassel, Simon & Al Taie, Amer & Steuten, Lotte, 2023. "Value assessment of antimicrobials using the STEDI framework – How steady is the outcome?," Health Policy, Elsevier, vol. 136(C).

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