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Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks: A Consensus Framework from a European Vaccine Economics Community

Author

Listed:
  • Bernhard Ultsch

    (Robert Koch Institute (RKI))

  • Oliver Damm

    (Bielefeld University)

  • Philippe Beutels

    (University of Antwerp)

  • Joke Bilcke

    (University of Antwerp)

  • Bernd Brüggenjürgen

    (Steinbeis University Berlin (SHB))

  • Andreas Gerber-Grote

    (Institute for Quality and Efficiency in Health Care (IQWiG))

  • Wolfgang Greiner

    (Bielefeld University)

  • Germaine Hanquet

    (Belgian Health Care Knowledge Centre (KCE))

  • Raymond Hutubessy

    (World Health Organization (WHO))

  • Mark Jit

    (London School of Hygiene and Tropical Medicine (LSHTM)
    Public Health England (PHE))

  • Mirjam Knol

    (Centre for Infectious Disease Control (RIVM))

  • Rüdiger Kries

    (Ludwig Maximilians University (LMU))

  • Alexander Kuhlmann

    (University of Hannover)

  • Daniel Levy-Bruhl

    (Institut de Veille Sanitaire (InVS))

  • Matthias Perleth

    (Federal Joint Committee (G-BA))

  • Maarten Postma

    (University of Groningen)

  • Heini Salo

    (National Institute for Health and Welfare (THL))

  • Uwe Siebert

    (University for Health Sciences, Medical Informatics and Technology (UMIT)
    ONCOTYROL, Center for Personalized Cancer Medicine)

  • Jürgen Wasem

    (University of Duisburg-Essen)

  • Ole Wichmann

    (Robert Koch Institute (RKI))

Abstract

Background Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist, several immunization-specific aspects (e.g. indirect effects or discounting approach) are still a subject of debate within the scientific community. Objective The objective of this study was to develop a consensus framework for HEEs of vaccines to support the development of national guidelines in Europe. Methods A systematic literature review was conducted to identify prevailing issues related to HEEs of vaccines. Furthermore, European experts in the field of health economics and immunization decision making were nominated and asked to select relevant aspects for discussion. Based on this, a workshop was held with these experts. Aspects on ‘mathematical modelling’, ‘health economics’ and ‘decision making’ were debated in group-work sessions (GWS) to formulate recommendations and/or—if applicable—to state ‘pros’ and ‘contras’. Results A total of 13 different aspects were identified for modelling and HEE: model selection, time horizon of models, natural disease history, measures of vaccine-induced protection, duration of vaccine-induced protection, indirect effects apart from herd protection, target population, model calibration and validation, handling uncertainty, discounting, health-related quality of life, cost components, and perspectives. For decision making, there were four aspects regarding the purpose and the integration of HEEs of vaccines in decision making as well as the variation of parameters within uncertainty analyses and the reporting of results from HEEs. For each aspect, background information and an expert consensus were formulated. Conclusions There was consensus that when HEEs are used to prioritize healthcare funding, this should be done in a consistent way across all interventions, including vaccines. However, proper evaluation of vaccines implies using tools that are not commonly used for therapeutic drugs. Due to the complexity of and uncertainties around vaccination, transparency in the documentation of HEEs and during subsequent decision making is essential.

Suggested Citation

  • Bernhard Ultsch & Oliver Damm & Philippe Beutels & Joke Bilcke & Bernd Brüggenjürgen & Andreas Gerber-Grote & Wolfgang Greiner & Germaine Hanquet & Raymond Hutubessy & Mark Jit & Mirjam Knol & Rüdiger, 2016. "Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks: A Consensus Framework from a European Vaccine Economics Community," PharmacoEconomics, Springer, vol. 34(3), pages 227-244, March.
    • Handle: RePEc:spr:pharme:v:34:y:2016:i:3:d:10.1007_s40273-015-0335-2
    DOI: 10.1007/s40273-015-0335-2
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    References listed on IDEAS

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    1. P. Thokala & A. Duenas, 2012. "Multiple Criteria Decision Analysis for Health Technology Assessment," Post-Print hal-00800398, HAL.
    2. Alan Brennan & Stephen E. Chick & Ruth Davies, 2006. "A taxonomy of model structures for economic evaluation of health technologies," Health Economics, John Wiley & Sons, Ltd., vol. 15(12), pages 1295-1310, December.
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    1. Elahe Khorasani & Majid Davari & Abbas Kebriaeezadeh & Farshad Fatemi & Ali Akbari Sari & Vida Varahrami, 2022. "A comprehensive review of official discount rates in guidelines of health economic evaluations over time: the trends and roots," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1577-1590, December.
    2. Ulrike Kuchenbecker & Daniela Chase & Anika Reichert & Julia Schiffner-Rohe & Mark Atwood, 2018. "Estimating the cost-effectiveness of a sequential pneumococcal vaccination program for adults in Germany," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-23, May.
    3. Mario Cesare Nurchis & Alberto Lontano & Domenico Pascucci & Martina Sapienza & Eleonora Marziali & Francesco Castrini & Rosaria Messina & Luca Regazzi & Francesco Andrea Causio & Andrea Di Pilla & Gi, 2022. "COVID-19 Vaccination Campaign among the Health Workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS: A Cost–Benefit Analysis," IJERPH, MDPI, vol. 19(13), pages 1-10, June.
    4. Hannah Christensen & Hareth Al-Janabi & Pierre Levy & Maarten J. Postma & David E. Bloom & Paolo Landa & Oliver Damm & David M. Salisbury & Javier Diez-Domingo & Adrian K. Towse & Paula K. Lorgelly & , 2020. "Economic evaluation of meningococcal vaccines: considerations for the future," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 297-309, March.

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