Recommendations to drive a value-based decision-making on vaccination

ABSTRACT

Introduction

Health systems worldwide need to pay attention to both sustainability and quality. The explosion of health technologies represents a challenge for health systems’ sustainability, and evidence-based tools should support resources allocation to guarantee a continuous quality improvement. The value-based approach could disentangle the full benefit of a health technology, and this is of utmost importance in the vaccination field because of several obstacles still existing in reaching optimal vaccination uptake.

Areas covered

The paper conveys the evidence on the full value of vaccine(s)/vaccination based on the framework suggested by the Expert Panel on Effective Ways of Investing in Health of the European Commission. Indeed, evidence on the personal, technical, allocative, and societal value of vaccine(s)/vaccination published in the last decade was described as foundation of a following consultation with international experts of the field. The result was the issuing of recommendations for research, decision-making, and public engagement that aimed to drive a value-based decision-making on vaccination.

Expert opinion

The development of vaccination programs based on the recognition of the full value of vaccine(s)/vaccination is essential. To achieve this goal, it is necessary to launch intersectoral and multidisciplinary research and implementation initiatives involving all relevant stakeholders.

KEYWORDS:

• Vaccination policies
• vaccines
• value
• value-based healthcare

Article highlights

• A value-based approach is envisaged to make decisions on vaccination because it represents a cornerstone of sustainable and high-quality health systems

• The evidence on the full value of vaccine(s)/vaccination is still scant and mainly focused on cost-effectiveness

• Also, in the vaccination field, the concept of value should embrace and exceed that of efficiency, taking into due consideration costs and health outcomes, but also the societal value. According to this perspective, the evolution toward a value-based vaccination must involve all relevant stakeholders (health authorities, health professionals, scientists, citizens, and industry)

• Improvement actions to drive a value-based decision-making on vaccination concern the research, the decision-making process, and the public engagement

• The generation and translation of new evidence and data on the full value of vaccine(s)/vaccination should be pursued together with their real incorporation in the decision-making process and in public engagement initiatives

• Investments in intersectoral research activities and infrastructures, as well as in strengthening of independent advisory groups and international collaborations represent a cornerstone for a future value-based decision-making on vaccination

Acknowledgments

We would like to thank Alessia Tognetto, Elettra Carini, Irene Giacchetta, Ester Bonanno and Marco Mariani for their support in the VIHTALI project. We would also like to thank Joseph Knee for English language revision of the paper.

The results of the VIHTALI project entitled “The value(s) of vaccination: building the scientific evidence according to a Value-Based Healthcare approach” were presented as abstracts at the 14th European Public Health Conference and at the 54th National Congress of the Italian Society of Hygiene, Preventive Medicine and Public Health (S.It.I.).

Declaration of Interests

This paper reports the results of a VIHTALI project entitled ‘The value(s) of vaccination: building the scientific evidence according to a Value-Based Healthcare approach.’ The project was funded by MSD. The funders of the Project had no role in the design of the study, the collection, analysis and interpretation of data, or the writing of the manuscript. C de Waure and G Elisa Calabrò received a fee by VIHTALI for the scientific coordination of the project. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization and methodology: Giovanna Elisa Calabrò; Definition of the search strategy: Giovanna Elisa Calabrò and Chiara de Waure; Elaboration of recommendations: Giovanna Elisa Calabrò and Chiara de Waure; Supervision: Walter Ricciardi; Validation of the recommendations: Value(s) of Vaccination Project Steering Committee (David Bloom, Americo Cicchetti, Siddhartha Sankar Datta, Giovanni Rezza, Luigi Siciliani, Mondher Toumi, York Zollner, Walter Ricciardi); Writing-original draft preparation: Giovanna Elisa Calabrò and Chiara de Waure; Writing-review and editing: Giovanna Elisa Calabrò, Chiara de Waure and Walter Ricciardi; Project administration and funding acquisition: Giovanna Elisa Calabrò. All authors have read and agreed to the published version of the manuscript.

Additional information

Funding

This manuscript was funded by V.I.H.T.A.L.I. (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, Rome, Italy. This paper reports the results of a VIHTALI project entitled ‘The value(s) of vaccination: building the scientific evidence according to a Value-Based Healthcare approach.’ The project was funded by MSD.