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Pérez A, Fernández Prada M, Cassinello N, Vallejo-Aparicio LA, García A, González A, Durán A, Zozaya N, Fernández I, Daheron M, Hidalgo Á, Beck E, García Ruiz A. Cost-benefit analysis of the National Immunization Program in Spain. Hum Vaccin Immunother 2024; 20:2385175. [PMID: 39161115 PMCID: PMC11340736 DOI: 10.1080/21645515.2024.2385175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024] Open
Abstract
Broad benefits of vaccination programs are well acknowledged but difficult to measure, especially when considering all vaccines included in a National Immunization Program (NIP). The aim was to conduct a cost-benefit analysis of the entire NIP in Spain, and an expanded NIP including four potential additional programs. A cost-benefit analysis was performed in Excel to assess the economic and health benefits (€) of vaccinating a single cohort of newborns over a lifetime horizon compared to no vaccination, from a societal perspective: firstly, according to the 2020 NIP in Spain (including 2021 recommendation for herpes zoster in 65-year-olds); and secondly, with an expanded NIP (adding rotavirus and meningococcal B in infants, and pertussis booster in adults aged >65 years and herpes zoster in all adults >50 years). The main inputs were taken from published literature and Spanish databases. Results were presented as a benefit-cost ratio (economic benefit per €1 invested). A cohort of 343,126 newborns were included in the analysis. The total investment needed to vaccinate the cohort throughout their lifetime, according to the 2020 NIP and the expanded NIP, was estimated at €168.5 million and €275.5 million, respectively. Potential economic benefits were €772.2 million and €803.0 million, respectively. The societal benefit-cost ratio was €4.58 and €2.91 per €1 invested, respectively. Even with the addition of new vaccination programs, the Spanish NIP yielded positive benefit-cost ratios from the societal perspective, demonstrating that NIPs spanning the full life course are an efficient public health measure.
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Affiliation(s)
- Alberto Pérez
- Management, Hospital Nuestra Señora De Sonsoles (Complejo Asistencial De Avila), Ávila, Spain
| | - María Fernández Prada
- Preventive Medicine and Public Health, Hospital Vital Alvarez Buylla, Asturias, Spain
| | - Natalia Cassinello
- Financial and Accounting Management, Universidad Pontificia Comillas, Madrid, Spain
| | | | | | | | - Ana Durán
- Health Economics and Market Access, Vivactis Weber, Madrid, Spain
| | - Néboa Zozaya
- Health Economics and Market Access, Vivactis Weber, Madrid, Spain
| | - Irene Fernández
- Health Economics and Market Access, Vivactis Weber, Madrid, Spain
| | - Mathilde Daheron
- Health Economics and Market Access, Vivactis Weber, Madrid, Spain
| | - Álvaro Hidalgo
- Weber Foundation, Madrid, Spain
- University of Castilla La Mancha, Toledo, Spain
| | | | - Antonio García Ruiz
- IBIMA Platform Bionand, Universidad de Málaga – IBIMA Platform Bionand, Málaga, Spain
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Gountas I, Favre-Bulle A, Saxena K, Wilcock J, Collings H, Salomonsson S, Skroumpelos A, Sabale U. Impact of the COVID-19 Pandemic on HPV Vaccinations in Switzerland and Greece: Road to Recovery. Vaccines (Basel) 2023; 11:vaccines11020258. [PMID: 36851136 PMCID: PMC9964352 DOI: 10.3390/vaccines11020258] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
The COVID-19 pandemic has caused significant disruptions to healthcare, including reduced administration of routinely recommended HPV vaccines in a number of European countries. Because the extent and trends of accumulated vaccine dose deficits may vary by country, decision-makers need country-specific information regarding vaccine deficits to plan effective catch-up initiatives. To address this knowledge gap in Switzerland and Greece, this study used a previously published COVID-19 recovery calculator and historical vaccine sales data to quantify the cumulative number of missed doses and the catch-up rate required to clear the deficit in Switzerland and Greece. The resultant cumulative deficit in HPV doses for Switzerland and Greece were 24.4% and 21.7%, respectively, of the total number of doses disseminated in 2019. To clear the dose deficit by December 2025, monthly vaccination rates must be increased by 6.3% and 6.0% compared to 2019 rates in Switzerland and Greece, respectively. This study demonstrates that administration rates of routine HPV vaccines decreased significantly among Swiss and Greek adolescents during the COVID-19 pandemic and that a sustained increase in vaccination rates is necessary to recover the HPV dose deficits identified and to prevent long-term public health consequences.
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Affiliation(s)
| | | | - Kunal Saxena
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ 07065, USA
| | | | | | - Stina Salomonsson
- Center for Observational and Real-World Evidence (CORE), MSD, 11330 Stockholm, Sweden
| | | | - Ugne Sabale
- Center for Observational and Real-World Evidence (CORE), MSD, 11330 Stockholm, Sweden
- Correspondence:
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Wangen KR, Zhu D, Wang J. Hepatitis B vaccination among 1997-2011 birth cohorts in rural China: the potential for further catch-up vaccination and factors associated with infant coverage rates. Hum Vaccin Immunother 2018; 15:228-234. [PMID: 30199310 PMCID: PMC6363131 DOI: 10.1080/21645515.2018.1520582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/14/2018] [Accepted: 08/27/2018] [Indexed: 01/27/2023] Open
Abstract
Hepatitis B vaccination rates in China have recently increased. This study aimed to investigate infant vaccination coverage for birth cohorts from 1997 to 2011 in rural regions and to assess catch-up vaccination potential. We used questionnaire-based interviews from a cross-section of 6,529 individuals from seven provinces. Logistic regression analyses were used to model two measures of infant vaccination status, namely, birth dose within 24 hours and three doses within the first year of life. During interviews, individuals' vaccination status and vaccination plan were recorded. Unvaccinated individuals without plans for future vaccination were presented with a hypothetical offer of free vaccination and indirect cost compensation. Institutional birth rates were higher than vaccination rates, but both increased over time. Vaccination coverage rates were not significantly associated with sex. Infant vaccination coverage was positively associated with a mother's educational level, household income level, knowledge of transmission routes, and perceived duration of protection obtained through vaccination. Vaccination status at the time of the survey showed the occurrence of catch-up vaccinations, but a notable percentage of individuals remained unvaccinated and had no plans for future vaccination. Of these individuals, approximately 50% were prepared to accept vaccination if offered free of charge.
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Affiliation(s)
- Knut Reidar Wangen
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jian Wang
- Center for Health Economics Experiment and Public Policy, School of Public Health, Shandong University, Jinan, China
- Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan, China
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Goyal A, Murray JM. Cost-Effectiveness of Peg-Interferon, Interferon and Oral Nucleoside Analogues in the Treatment of Chronic Hepatitis B and D Infections in China. Clin Drug Investig 2016; 36:637-48. [DOI: 10.1007/s40261-016-0409-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Drake TL, Devine A, Yeung S, Day NPJ, White LJ, Lubell Y. Dynamic Transmission Economic Evaluation of Infectious Disease Interventions in Low- and Middle-Income Countries: A Systematic Literature Review. HEALTH ECONOMICS 2016; 25 Suppl 1:124-39. [PMID: 26778620 PMCID: PMC5066646 DOI: 10.1002/hec.3303] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Economic evaluation using dynamic transmission models is important for capturing the indirect effects of infectious disease interventions. We examine the use of these methods in low- and middle-income countries, where infectious diseases constitute a major burden. This review is comprised of two parts: (1) a summary of dynamic transmission economic evaluations across all disease areas published between 2011 and mid-2014 and (2) an in-depth review of mosquito-borne disease studies focusing on health economic methods and reporting. Studies were identified through a systematic search of the MEDLINE database and supplemented by reference list screening. Fifty-seven studies were eligible for inclusion in the all-disease review. The most common subject disease was HIV/AIDS, followed by malaria. A diverse range of modelling methods, outcome metrics and sensitivity analyses were used, indicating little standardisation. Seventeen studies were included in the mosquito-borne disease review. With notable exceptions, most studies did not employ economic evaluation methods beyond calculating a cost-effectiveness ratio or net benefit. Many did not adhere to health care economic evaluations reporting guidelines, particularly with respect to full model reporting and uncertainty analysis. We present a summary of the state-of-the-art and offer recommendations for improved implementation and reporting of health economic methods in this crossover discipline.
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Affiliation(s)
- Tom L Drake
- University of Oxford, Oxford, UK
- Mahidol University, Bangkok, Thailand
| | - Angela Devine
- University of Oxford, Oxford, UK
- Mahidol University, Bangkok, Thailand
| | - Shunmay Yeung
- London School of Hygiene and Tropical Medicine, London, UK
| | - Nicholas P J Day
- University of Oxford, Oxford, UK
- Mahidol University, Bangkok, Thailand
| | - Lisa J White
- University of Oxford, Oxford, UK
- Mahidol University, Bangkok, Thailand
| | - Yoel Lubell
- University of Oxford, Oxford, UK
- Mahidol University, Bangkok, Thailand
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Juusola JL, Brandeau ML. HIV Treatment and Prevention: A Simple Model to Determine Optimal Investment. Med Decis Making 2015; 36:391-409. [PMID: 26369347 DOI: 10.1177/0272989x15598528] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 06/19/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To create a simple model to help public health decision makers determine how to best invest limited resources in HIV treatment scale-up and prevention. METHOD A linear model was developed for determining the optimal mix of investment in HIV treatment and prevention, given a fixed budget. The model incorporates estimates of secondary health benefits accruing from HIV treatment and prevention and allows for diseconomies of scale in program costs and subadditive benefits from concurrent program implementation. Data sources were published literature. The target population was individuals infected with HIV or at risk of acquiring it. Illustrative examples of interventions include preexposure prophylaxis (PrEP), community-based education (CBE), and antiretroviral therapy (ART) for men who have sex with men (MSM) in the US. Outcome measures were incremental cost, quality-adjusted life-years gained, and HIV infections averted. RESULTS Base case analysis indicated that it is optimal to invest in ART before PrEP and to invest in CBE before scaling up ART. Diseconomies of scale reduced the optimal investment level. Subadditivity of benefits did not affect the optimal allocation for relatively low implementation levels. The sensitivity analysis indicated that investment in ART before PrEP was optimal in all scenarios tested. Investment in ART before CBE became optimal when CBE reduced risky behavior by 4% or less. Limitations of the study are that dynamic effects are approximated with a static model. CONCLUSIONS Our model provides a simple yet accurate means of determining optimal investment in HIV prevention and treatment. For MSM in the US, HIV control funds should be prioritized on inexpensive, effective programs like CBE, then on ART scale-up, with only minimal investment in PrEP.
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Affiliation(s)
- Jessie L Juusola
- Department of Management Science and Engineering, Stanford University, Stanford, CA (JLJ, MLB)
| | - Margaret L Brandeau
- Department of Management Science and Engineering, Stanford University, Stanford, CA (JLJ, MLB)
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Creating impact with operations research in health: making room for practice in academia. Health Care Manag Sci 2015; 19:305-312. [PMID: 26003321 DOI: 10.1007/s10729-015-9328-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 05/18/2015] [Indexed: 01/02/2023]
Abstract
Operations research (OR)-based analyses have the potential to improve decision making for many important, real-world health care problems. However, junior scholars often avoid working on practical applications in health because promotion and tenure processes tend to value theoretical studies more highly than applied studies. This paper discusses the author's experiences in using OR to inform and influence decisions in health and provides a blueprint for junior researchers who wish to find success by taking a similar path. This involves selecting good problems to study, forming productive collaborations with domain experts, developing appropriate models, identifying the most salient results from an analysis, and effectively disseminating findings to decision makers. The paper then suggests how journals, funding agencies, and senior academics can encourage such work by taking a broader and more informed view of the potential role and contributions of OR to solving health care problems. Making room in academia for the application of OR in health follows in the tradition begun by the founders of operations research: to work on important real-world problems where operations research can contribute to better decision making.
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