Abstract
The high price of new generations of vaccines relative to their predecessors has become an important consideration in debates over whether the benefits of the new vaccines justify their costs. An increasingly central line of inquiry in the literature on valuing vaccination surrounds accounting for the full social and economic benefits of vaccination. This paper applies this emerging perspective to the particular case of vaccination against serogroup B meningococcal disease (MenB). We explore key issues involved in health technology assessments of MenB vaccination, which have led to pronounced heterogeneity in evaluation methods and recommendation outcomes across countries such as France, Germany, the US, and the UK. Accounting for typically neglected sources of socioeconomic benefit could potentially impact recommendation and reimbursement decisions. We propose a taxonomy of such benefits built around four dimensions: (i) internalized health benefits, (ii) internalized non-health benefits, (iii) externalized health benefits, and (iv) externalized non-health benefits. This approach offers a systematic, comprehensive evaluation framework that can be used in future assessment of MenB vaccines as well as other health technologies.
Highlights
Considerable discussion has surrounded the rising costs of vaccines in recent years [1]
This paper focuses on valuation in the unique context of most defining features of serogroup B (MenB), though many of the concepts and issues discussed are broadly applicable to meningococcal disease in general and other infectious diseases as well
Al-Janabi et al find that the quality-adjusted life year (QALY) loss among families and caregivers of those with meningitis sequelae is 16% of the loss experienced by the disabled person, largely owing to increased rates of anxiety and depression [60]
Summary
Considerable discussion has surrounded the rising costs of vaccines in recent years [1]. Unnecessary preventable health burdens and their downstream social and economic consequences are an unfortunate possibility under circumstances of such undervaluation Along these lines, traditional economic evaluations of MenB and other meningococcal vaccines typically ignore or undercount several plausibly substantial benefits. This paper expands upon the literature’s taxonomy of vaccination benefits to include socioeconomic aspects often unaccounted for by conventional, health-centric economic evaluation methods Our exploration of this concept aims to broaden analysts’ and policymakers’ understanding of the scope and probable magnitude of vaccination benefits in general. The UK’s experience with economic evaluations of MenB illustrates how adopting a broad benefits perspective can help resolve some of these issues and influence recommendation decisions Supplementing those benefits considered by the UK, we present a comprehensive framework for conceptualizing the full value of vaccination from a societal perspective.
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