Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, the Netherlands; Department of Pharmacology & Therapy, Universitas Airlangga, Surabaya, Indonesia; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.
GSK, Wavre, Belgium.
Vaccine. 2022 Jun 26;40(30):3999-4007. doi: 10.1016/j.vaccine.2022.04.026. Epub 2022 May 18.
A value of vaccination framework for economic evaluation (EE) identified unique value concepts for the broad benefits vaccination provides to individuals, society, healthcare systems and national economies. The objectives of this paper were to work with experts in developed countries to objectively identify three priority concepts to extend current EE.
The previously developed classification of value concepts in vaccination distinguished 18 concepts, categorised as conventional payer and societal perspective concepts and novel broader societal concepts. Their inclusion in current EE guidelines was assessed. Experts identified eight criteria relevant to decision-making and measurement feasibility, which were weighted and used to score each concept. The relative ranking of concepts by importance and the gaps in guidelines were used to identify three priority concepts on which to focus immediate efforts to extend EE.
The EE guidelines review highlighted differences across countries and between guidelines and practice. Conventional payer perspective concepts (e.g., individual and societal health gains and medical costs) were generally included, while gaps were evident for conventional societal perspective concepts (e.g., family/caregiver health and economic gains). Few novel broader societal benefits were considered, and only in ad hoc cases. The top-three concepts for near-term consideration: macroeconomic gains (e.g., benefiting the economy, tourism), social equity and ethics (e.g., equal distribution of health outcomes, reduced health/financial equity gaps) and health systems strengthening, resilience and security (e.g., efficiency gains, reduced disruption, increased capacity).
Gaps, inconsistencies and limited assessment of vaccination value in EE can lead to differences in policy and vaccination access. The three priority concepts identified provide a feasible approach for capturing VoV more broadly in the near-term. Robust methods for measuring and valuing these concepts in future assessments will help strengthen the evidence used to inform decisions, improving access to vaccines that are demonstrably good value for money from society's point of view.
疫苗经济学评价（EE）的价值框架确定了疫苗为个人、社会、医疗保健系统和国家经济带来广泛益处所具有的独特价值概念。本文的目的是与发达国家的专家合作，客观地确定三个优先概念，以扩展当前的 EE。
先前开发的疫苗价值概念分类区分了 18 个概念，分为常规支付方和社会视角概念以及新颖的更广泛的社会概念。评估了它们在当前 EE 指南中的纳入情况。专家确定了与决策和测量可行性相关的八项标准，这些标准被加权并用于对每个概念进行评分。根据重要性和指南中的差距对概念进行相对排名，以确定三个优先概念，重点关注立即扩大 EE 的努力。
EE 指南审查突出了国家之间以及指南与实践之间的差异。常规支付方视角的概念（例如，个人和社会健康收益和医疗成本）通常被包括在内，而常规社会视角的概念（例如，家庭/照顾者健康和经济收益）则存在差距。很少考虑到新颖的更广泛的社会利益，而且只是在特定情况下。近期需要考虑的三个优先概念：宏观经济收益（例如，有利于经济、旅游业）、社会公平和伦理（例如，健康结果的平等分配、减少健康/财务公平差距）以及卫生系统的加强、弹性和安全（例如，效率提高、减少中断、能力增强）。
EE 中疫苗价值评估的差距、不一致和有限评估可能导致政策和疫苗可及性的差异。确定的三个优先概念为在近期更广泛地捕获 VoV 提供了可行的方法。在未来的评估中，用于衡量和评估这些概念的稳健方法将有助于加强用于为决策者提供信息的证据，从而改善从社会角度来看具有明显价值的疫苗的可及性。
