Lieu Tracy A, Thompson Kimberly M, Prosser Lisa A, O'Brien Megan A, Yusuf Hussain R, Shefer Abigail M, Weinstein Milton C, Rickert Donna L
Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, MA 02215, USA.
Expert Rev Vaccines. 2002 Dec;1(4):433-42. doi: 10.1586/14760584.1.4.433.
Economic studies of vaccines, including vaccine development and delivery issues, are increasingly needed to inform policy recommendations and programmatic decisions in the USA. This need arises from the increasing costs of vaccines, the complexity of the US healthcare system and the limited number of vaccine manufacturers in the market. We have developed a national research agenda in domestic and global vaccine economics by conducting key informant interviews with 42 experts and inviting ideas from an additional 128 experts. To assess priorities among the 129 ideas that were generated, we asked 15 experts representing a broad range of perspectives to rank the ideas and we analyzed their votes. The highest-ranking domestic research ideas included evaluating: the costs of vaccine shortages, the cost-effectiveness of potential human papillomavirus vaccination and adult and adolescent pertussis vaccination programs and the cost-effectiveness of universal vaccine purchase programs for adults as well as children. The highest-ranking globally-oriented ideas included developing a resource allocation model to support the best vaccination program decisions with limited funds and assessing the cost-effectiveness of HIV, rotavirus, meningococcal and malaria vaccines in developing countries. To optimize the usefulness of vaccine economics research, conceptual issues, such as how to set values for the prevention of illness and how to maximize social equity through investments in vaccines, must be addressed.
在美国，越来越需要对疫苗进行经济学研究，包括疫苗研发和供应问题，以便为政策建议和项目决策提供依据。这种需求源于疫苗成本不断上升、美国医疗体系的复杂性以及市场上疫苗制造商数量有限。我们通过对42位专家进行关键信息访谈，并邀请另外128位专家提出想法，制定了国内和全球疫苗经济学的国家研究议程。为了评估所产生的129个想法的优先级，我们邀请了15位代表广泛观点的专家对这些想法进行排序，并分析他们的投票。排名最高的国内研究想法包括评估：疫苗短缺的成本、潜在的人乳头瘤病毒疫苗接种以及成人和青少年百日咳疫苗接种计划的成本效益，以及成人和儿童通用疫苗采购计划的成本效益。排名最高的全球导向性想法包括开发一种资源分配模型，以在资金有限的情况下支持最佳疫苗接种计划决策，以及评估发展中国家艾滋病毒、轮状病毒、脑膜炎球菌和疟疾疫苗的成本效益。为了优化疫苗经济学研究的实用性，必须解决一些概念性问题，例如如何为疾病预防设定价值，以及如何通过对疫苗的投资实现社会公平最大化。
