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Riley AG, Voehler D, Mitrovich R, Carias C, Ollendorf DA, Nelson KL, Synnott PG, Eiden AL. Documenting the Full Value of Vaccination: A Systematic Review of Value Frameworks. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:1289-1299. [PMID: 38729562 DOI: 10.1016/j.jval.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 04/12/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES Economic evaluations of vaccination may not fully account for nonhealth patient impacts on families, communities, and society (ie, broader value elements). Omission of broader value elements may reflect a lack of established measurement methodology, lack of agreement over which value elements to include in economic evaluations, and a lack of consensus on whether the value elements included should vary by vaccination type or condition. We conducted a systematic review of value frameworks to identify broader value elements and measurement guidance that may be useful for capturing the full value of vaccination. METHODS We searched Ovid MEDLINE, PubMed, Embase, and the gray literature to identify value frameworks for all health interventions, and we extracted information on each framework's context, value elements, and any available guidance on how these elements should be measured. We used descriptive statistics to analyze and compare the prevalence of broader value elements in vaccination value frameworks and other healthcare-related value frameworks. RESULTS Our search identified 62 value frameworks that met inclusion criteria, 9 of which were vaccination specific. Although vaccination frameworks included several broader value elements, such as reduced transmissibility and public health benefits, the elements were represented inconsistently across the frameworks. Vaccination frameworks omitted several value elements included in nonvaccination-specific frameworks, including dosing and administration complexity and affordability. In addition, guidance for measuring broader value elements was underdeveloped. CONCLUSIONS Future efforts should further evaluate inclusion of broader value elements in economic evaluations of vaccination and develop standards for their subsequent measurement.
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Affiliation(s)
- Abigail G Riley
- Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA.
| | - Dominic Voehler
- Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA
| | | | | | - Daniel A Ollendorf
- Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA
| | | | - Patricia G Synnott
- Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA
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2
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Michel J. How can precision health care contribute to healthy aging? Aging Med (Milton) 2024; 7:269-271. [PMID: 38975306 PMCID: PMC11222728 DOI: 10.1002/agm2.12333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 07/09/2024] Open
Abstract
The future of medicine will be closely linked to technological progress, to the great benefit of aging adults. Increasing knowledge in fields encompassing biology, physiology and functioning of the aging process, combined with the early detection of non-clinically apparent but significant changes will make it possible to promote healthy aging.
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Affiliation(s)
- Jean‐Pierre Michel
- University of GenevaGenevaSwitzerland
- French Academy of MedicineParisFrance
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3
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Missed Opportunities for Vaccination and Associated Factors among Children Attending Primary Health Care Facilities in Cape Town, South Africa: A Pre-Intervention Multilevel Analysis. Vaccines (Basel) 2022; 10:vaccines10050785. [PMID: 35632542 PMCID: PMC9144782 DOI: 10.3390/vaccines10050785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/04/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the substantial efforts at ensuring universal access to routine immunisation services among children in South Africa, major gaps in immunisation coverage remain. This study assessed the magnitude of missed opportunities for vaccination (MOV) and associated factors among children aged 0–23 months attending primary health care (PHC) facilities in Cape Town. We used multilevel binomial logistic regression models to explore individual and contextual factors associated with MOV, with children aged 0–23 months at Level 1, nested within PHC facilities (Level 2). A total of 674 children and their caregivers were enrolled. MOV prevalence was 14.1%, ranging from 9.1% to 18.9% across sub-districts. Dose-specific MOV prevalence was highest for the second dose of measles vaccine (9.5%) and lowest for the first dose of rotavirus vaccine (0.6%). The likelihood of a child experiencing MOV was significantly associated with caregivers’ low level of education (Odds ratio (OR) = 3.53, 95% credible interval (CrI): 1.13–11.03), recent receipt of immunisation messages (OR = 0.46, 95%CrI: 0.25–0.87), shared immunisation decision making by both parents (OR = 0.21, 95%CrI: 0.07–0.62) and health facility staff number (OR = 0.18, 95%CrI: 0.06–0.61). The burden of MOV among children in Cape Town is influenced by individual and contextual factors, which provide important opportunities for quality improvement and broader strategies to improve routine immunisation service delivery.
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Youdom SW, Njinkui DN, Nguefack-Tsague G, Ateudjieu J. Missed Opportunities for Vaccination and Associated Factors among Children Aged 12 - 23 Months in Cameroon: Further Analyses of 2018 Cameroon Demographic and Health Survey. Health (London) 2022. [DOI: 10.4236/health.2022.1410077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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COVID-19 and the Gaping Wounds of South Africa's Suboptimal Immunisation Coverage: An Implementation Research Imperative for Assessing and Addressing Missed Opportunities for Vaccination. Vaccines (Basel) 2021; 9:vaccines9070691. [PMID: 34201684 PMCID: PMC8310047 DOI: 10.3390/vaccines9070691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
Despite South Africa's substantial investments in and efforts at ensuring universal access to immunisation services, progress has stalled and remains suboptimal across provinces and districts. An additional challenge is posed by the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has disrupted immunisation services globally, including in South Africa. While there is growing evidence that missed opportunities for vaccination (MOV) are a major contributor to suboptimal immunisation progress globally, not much is known about the burden and determinants of MOV in the South African context. Herein, we make a case for assessing MOV as a strategy to address current immunisation coverage gaps while mitigating the adverse impacts of the COVID-19 pandemic on immunisation services. We illustrate a practical implementation research approach to assessing the burden of MOV among children in primary care settings; for understanding the factors associated with MOV; and for designing, implementing, and evaluating context-appropriate quality improvement interventions for addressing missed opportunities. Such efforts are vital for building health system resilience and maintaining immunisation programme capacity to optimally deliver essential health services such as routine childhood immunisation, even during pandemics.
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Zozaya González N, Alcalá Revilla B, Arrazola Martínez P, Chávarri Bravo JR, Cuesta Esteve I, García Rojas AJ, Martinón-Torres F, Redondo Margüello E, Rivero Cuadrado A, Tamames Gómez S, Villaseca Carmena J, Hidalgo-Vega A. Pathway towards an ideal and sustainable framework agreement for the public procurement of vaccines in Spain: a multi-criteria decision analysis. Hum Vaccin Immunother 2020; 16:2873-2884. [PMID: 32243235 PMCID: PMC7733903 DOI: 10.1080/21645515.2020.1732164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective: To advance the development of an ideal and sustainable framework agreement for the public procurement of vaccines in Spain, and to agree on the desirable award criteria and their relative weight. Methods: A multidisciplinary committee of seven health-care professionals and managers developed a partial multi-criteria decision analysis to determine the award criteria that should be considered and their specific weights for the public procurement of routine vaccines and seasonal influenza vaccines, considering their legal viability. A re-test of the results was carried out. The current situation was analyzed through 118 tender specifications and compared to the ideal framework. Results: Price is the prevailing award criterion for the public procurement of both routine (weighting of 60% versus 40% for all other criteria) and influenza (36% versus 64%) vaccines. Ideally, 22 criteria should be considered for routine vaccines, grouped and weighted into five domains: efficacy (weighting of 29%), economic aspects (27%), vaccine characteristics (22%), presentation form and packaging (13%), and others (9%). Per criteria set, price was the most important criterion (22%), followed by effectiveness (9%), and composition/formulation (7%). Regarding influenza vaccines, 20 criteria were selected, grouped, and weighted: efficacy (29%), economic aspects (25%), vaccine characteristics (20%), presentation form and packaging (16%), and others (11%). Per criteria set, price was also the most relevant criterion (19%), followed by composition/formulation (8%), and effectiveness (8%). Conclusions: Contrary to the current approach, technical award criteria should prevail over economic criteria in an ideal and sustainable framework agreement for the public procurement of vaccines.
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Affiliation(s)
- N Zozaya González
- Health Economics Department, Weber , Madrid, Spain.,University of Las Palmas de Gran Canaria , Las Palmas, Spain
| | - B Alcalá Revilla
- Servicio de Medicina Preventiva, Hospital Universitario 12 de Octubre , Madrid, Spain
| | | | - J R Chávarri Bravo
- Unidad de Vacunas, Subdirección de Salud Pública de Zaragoza , Zaragoza, Spain
| | | | - A J García Rojas
- Servicio de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Genetics, Vaccines and Pediatrics Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela
| | - F Martinón-Torres
- Centro de Salud Internacional Ayuntamiento de Madrid, Grupo de Trabajo de Actividades Preventivas de la Sociedad Española de Médicos de Atención Primaria
| | | | - A Rivero Cuadrado
- Servicio de Epidemiología, Dirección General de Salud Pública de la Junta de Castilla y León
| | | | - J Villaseca Carmena
- Servicio de Medicina Preventiva, Hospital Universitario 12 de Octubre , Madrid, Spain
| | - A Hidalgo-Vega
- Departamento de Fundamentos de Análisis Económico, Universidad de Castilla la Mancha
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Oliveira MD, Mataloto I, Kanavos P. Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:891-918. [PMID: 31006056 PMCID: PMC6652169 DOI: 10.1007/s10198-019-01052-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 03/14/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND Multi-criteria decision analysis (MCDA) concepts, models and tools have been used increasingly in health technology assessment (HTA), with several studies pointing out practical and theoretical issues related to its use. This study provides a critical review of published studies on MCDA in the context of HTA by assessing their methodological quality and summarising methodological challenges. METHODS A systematic review was conducted to identify studies discussing, developing or reviewing the use of MCDA in HTA using aggregation approaches. Studies were classified according to publication time and type, country of study, technology type and study type. The PROACTIVE-S approach was constructed and used to analyse methodological quality. Challenges and limitations reported in eligible studies were collected and summarised; this was followed by a critical discussion on research requirements to address the identified challenges. RESULTS 129 journal articles were eligible for review, 56% of which were published in 2015-2017; 42% focused on pharmaceuticals; 36, 26 and 18% reported model applications, issues regarding MCDA implementation analyses, and proposing frameworks, respectively. Poor compliance with good methodological practice (< 25% complying studies) was found regarding behavioural analyses, discussion of model assumptions and uncertainties, modelling of value functions, and dealing with judgment inconsistencies. The five most reported challenges related to evidence and data synthesis; value system differences and participant selection issues; participant difficulties; methodological complexity and resource balance; and criteria and attributes modelling. A critical discussion on ways to address these challenges ensues. DISCUSSION Results highlight the need for advancement in robust methodologies, procedures and tools to improve methodological quality of MCDA in HTA studies. Research pathways include developing new model features, good practice guidelines, technologies to enable participation and behavioural research.
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Affiliation(s)
- Mónica D Oliveira
- CEG-IST, Universidade de Lisboa, Avenida Rovisco Pais, 1049-001, Lisbon, Portugal.
| | - Inês Mataloto
- CEG-IST, Universidade de Lisboa, Avenida Rovisco Pais, 1049-001, Lisbon, Portugal
| | - Panos Kanavos
- Department of Health Policy and Medical Technology Research Group, LSE Health London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
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Glaize A, Duenas A, Di Martinelly C, Fagnot I. Healthcare decision-making applications using multicriteria decision analysis: A scoping review. JOURNAL OF MULTI-CRITERIA DECISION ANALYSIS 2019. [DOI: 10.1002/mcda.1659] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Annabelle Glaize
- Management Department; IÉSEG School of Management, LEM-CNRS (UMR 9221)
| | - Alejandra Duenas
- Business Environment; ICN Business School, CERFIGE; Nancy France
| | | | - Isabelle Fagnot
- Management Department; Audencia Business School; Nantes France
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Balcha TT. Establishing Health Biotech and Enhancing Local Manufacturing of Pharmaceuticals in Sub-Saharan Africa. Glob Adv Health Med 2018; 7:2164956118809685. [PMID: 30450268 PMCID: PMC6236473 DOI: 10.1177/2164956118809685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/02/2018] [Accepted: 09/26/2018] [Indexed: 11/16/2022] Open
Abstract
Although many nations in Sub-Saharan Africa (SSA) have recently recorded impressive economic growth, and several countries could attain middle-income status in the next decade, there is no or little concurrent advance in health biotech with little capabilities for manufacturing of medicines, medical supplies, and health commodities in the region. They import majority of medicines, medical supplies, and health commodities used in national programs including immunization, family planning, tuberculosis, HIV, and malaria that drive health outcomes and population-level impact with supports mainly obtained from high-income countries, multilateral agencies, or philanthropies. Nevertheless, there is a growing global debate that countries should graduate from receiving development assistance which goes to the most important health programs like immunization when nations transition from low-income to middle-income economic status. Since sudden withdrawal of all or partial development assistance could send a shock to the health care and dent the trajectory toward achieving the health Sustainable Development Goal, it is imperative to urgently establish or strengthen health biotech and enhance manufacturing of pharmaceuticals in SSA.
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Affiliation(s)
- Taye T Balcha
- Office of the Director General, Armauer Hansen Research Institute, Addis Ababa, Ethiopia.,Department of Translational Medicine, Clinical Infection Medicine, Lund University, Malmö, Sweden
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St-Martin G, Lindstrand A, Sandbu S, Fischer TK. Selection and Interpretation of Scientific Evidence in Preparation for Policy Decisions: A Case Study Regarding Introduction of Rotavirus Vaccine Into National Immunization Programs in Sweden, Norway, Finland, and Denmark. Front Public Health 2018; 6:131. [PMID: 29868539 PMCID: PMC5960676 DOI: 10.3389/fpubh.2018.00131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/17/2018] [Indexed: 11/13/2022] Open
Abstract
The World Health Organization recommends inclusion of rotavirus vaccines in national immunization programs (NIPs) worldwide. Nordic countries are usually considered comparable in terms of demographics and health-care services and have comparable rotavirus disease burden. Nevertheless, the countries have reached different decisions regarding rotavirus vaccine: Norway and Finland have already introduced rotavirus vaccines into their NIPs and Sweden is currently changing its recommendation and vaccines will now be introduced on a national scale while Denmark has decided against it. This study focuses on the selection and interpretation of medical and epidemiological evidence used during the decision-making processes in Sweden, Norway, Finland, and Denmark. The so-called "severity criteria" is identified as one of the main reasons for the different policy decisions reached across the Nordic countries.
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Affiliation(s)
- Gry St-Martin
- Virology Surveillance and Research Unit, Statens Serum Institut, Copenhagen, Denmark
| | | | - Synne Sandbu
- Department of Vaccine Preventable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Thea Kølsen Fischer
- Virology Surveillance and Research Unit, Statens Serum Institut, Copenhagen, Denmark.,Center for Global Health, Department of Infectious Diseases, University of Southern Denmark, Odense, Denmark
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Sundaram N, Duckett K, Yung CF, Thoon KC, Sidharta S, Venkatachalam I, Chow A, Yoong J. “I wouldn’t really believe statistics” – Challenges with influenza vaccine acceptance among healthcare workers in Singapore. Vaccine 2018. [DOI: 10.1016/j.vaccine.2018.02.102] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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