Economic evaluation of vaccines: specificities and future challenges illustrated by recent European examples

Abstract

This study reviews the current challenges in the economic evaluation of vaccines with a focus on European countries. In particular, the type of clinical evidence generally available, the impact of discounting for time preference and the use of modeling to derive valid cost–effectiveness assessments are considered. First, the characteristics of evidence for vaccines are discussed, as well as potential difficulties faced when using evidence-based medicine applied to curative drugs to interpret vaccine evidence. Then, discounting is considered and specific examples illustrating issues with different types of discounting are described, taking HPV as the example. Finally, the need for sometimes complex dynamic models for vaccines is explored, and specific types of models are reviewed, keeping into consideration the adage “complex when needed, straightforward if allowed.”

Keywords::

• cost–effectiveness
• health economics
• prevention
• vaccines

Financial & competing interests

M Postma has received a research grant from Sanofi Pasteur MSD to work on this project. He has also received grants, honoraria and travel stipends from various pharmaceutical companies, including those interested in vaccines. Next to being a guest researcher at the University of Groningen, T Westra is currently employed at GlaxoSmithKline, Zeist (The Netherlands); this work was developed while employed at the University of Groningen. N Largeron and S Quilici are employees of Sanofi Pasteur MSD. 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.

No writing assistance was utilized in the production of this manuscript.