Bärnighausen Till, Bloom David E, Cafiero-Fonseca Elizabeth T, O'Brien Jennifer Carroll
Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115; and Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba 3935, South Africa.
Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115; and
Proc Natl Acad Sci U S A. 2014 Aug 26;111(34):12313-9. doi: 10.1073/pnas.1400475111. Epub 2014 Aug 18.
Vaccination has led to remarkable health gains over the last century. However, large coverage gaps remain, which will require significant financial resources and political will to address. In recent years, a compelling line of inquiry has established the economic benefits of health, at both the individual and aggregate levels. Most existing economic evaluations of particular health interventions fail to account for this new research, leading to potentially sizable undervaluation of those interventions. In line with this new research, we set forth a framework for conceptualizing the full benefits of vaccination, including avoided medical care costs, outcome-related productivity gains, behavior-related productivity gains, community health externalities, community economic externalities, and the value of risk reduction and pure health gains. We also review literature highlighting the magnitude of these sources of benefit for different vaccinations. Finally, we outline the steps that need to be taken to implement a broad-approach economic evaluation and discuss the implications of this work for research, policy, and resource allocation for vaccine development and delivery.
在上个世纪，疫苗接种已带来了显著的健康收益。然而，巨大的覆盖差距依然存在，这需要大量资金和政治意愿来解决。近年来，一系列引人注目的研究确定了健康在个人和总体层面的经济效益。现有的大多数针对特定健康干预措施的经济评估未能考虑到这项新研究，导致对这些干预措施的潜在低估幅度可能很大。与这项新研究一致，我们提出了一个框架，用于概念化疫苗接种的全部益处，包括避免的医疗费用、与结果相关的生产力提高、与行为相关的生产力提高、社区健康外部性、社区经济外部性以及降低风险和纯粹健康收益的价值。我们还回顾了强调不同疫苗这些益处来源规模的文献。最后，我们概述了实施广泛方法经济评估需要采取的步骤，并讨论了这项工作对疫苗研发和交付的研究、政策及资源分配的影响。
