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Cost Effectiveness and Resource Allocation

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01-12-2020 | Vaccination | Methodology

A comprehensive framework for considering additional unintended consequences in economic evaluation

Authors: Liv Nymark, Anna Vassall

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2020

Abstract

Background

In recent years there has been a growth in economic evaluations that consider indirect health benefits to populations due to advances in mathematical modeling. In addition, economic evaluations guidelines have suggested the inclusion of impact inventories to include non-health direct and indirect consequences. We aim to bring together this literature, together with the broader literature on internalities and externalities to propose a comprehensive approach for analysts to identify and characterize all unintended consequences in economic evaluations.

Methods

We present a framework to assist analysts identify and characterize additional costs and effects beyond that of direct health impact primarily intended to be influenced by the intervention/technology. We build on previous checklists to provide analysts with a comprehensive framework to justify the inclusion or exclusion of effects, supporting the use of current guidelines, to ensure any unintended effects are considered. We illustrate this framework with examples from immunization. These were identified from a previous systematic review, PhD thesis work, and general search scoping in PubMed databases.

Results

We present a comprehensive framework to consider additional consequences, exemplified by types and categories. We bring this and other guidance together to assist analysts identify possible unintended consequences whether taking a provider or societal perspective.

Conclusions

Although there are many challenges ahead to standardize the inclusion of additional consequences in economic evaluation, we hope by moving beyond generic statements to reporting against a comprehensive framework of additional effects we can support further consistency in this aspect of cost-effectiveness analysis going forward.

Rudmik L, Drummond M. Health economic evaluation: important principles and methodology. Laryngoscope. 2013;123(6):1341–7.PubMed

Edwards RT, Charles JM, Lloyd-Williams H. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues. BMC Public Health. 2013;13:1001.PubMedPubMedCentral

Byford S, Raftery J. Perspectives in economic evaluation. BMJ. 1998;316(7143):1529–30.PubMedPubMedCentral

Drummond MF, Jefferson TO. Guidelines for authors and peer reviewers of economic submissions to the BMJ. The BMJ Economic Evaluation Working Party. BMJ. 1996;313(7052):275–83.PubMedPubMedCentral

Husereau D, Drummond M, Petrou S, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS)–explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health. 2013;16(2):231–50.PubMed

Claxton K, Revill P, Sculpher M, Wilkinson T, Cairns J, Briggs A. The gates reference case for economic evaluation. Seattle: The Bill and Melinda Gates Foundation; 2014.

Sanders GD, Neumann PJ, Basu A, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA. 2016;316(10):1093–103.PubMed

Lakdawalla DN, Doshi JA, Garrison LP Jr, Phelps CE, Basu A, Danzon PM. Defining elements of value in health care-a health economics approach: an ISPOR Special Task Force Report [3]. Value Health. 2018;21(2):131–9.PubMed

Ultsch B, Damm O, Beutels P, et al. Methods for health economic evaluation of vaccines and immunization decision frameworks: a consensus framework from a European Vaccine Economics Community. Pharmacoeconomics. 2016;34(3):227–44.PubMed

10.

Pitman R, Fisman D, Zaric GS, et al. Dynamic transmission modeling: a report of the ISPOR-SMDM modeling good research practices task force-5. Value Health. 2012;15(6):828–34.PubMedPubMedCentral

11.

Mauskopf J, Standaert B, Connolly MP, et al. Economic analysis of vaccination programs: an ISPOR good practices for outcomes research task force report. Value Health. 2018;21(10):1133–49.PubMed

12.

Deogaonkar R, Hutubessy R, van der Putten I, Evers S, Jit M. Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries. BMC Public Health. 2012;12:878.PubMedPubMedCentral

13.

Ozawa S, Mirelman A, Stack ML, Walker DG, Levine OS. Cost-effectiveness and economic benefits of vaccines in low- and middle-income countries: a systematic review. Vaccine. 2012;31(1):96–108.PubMed

14.

Barnighausen T, Bloom DE, Canning D, O’Brien J. Accounting for the full benefits of childhood vaccination in South Africa. S Afr Med J. 2008;98(11):842–6.PubMed

15.

Nymark LS, Sharma T, Miller A, Enemark U, Griffiths UK. Inclusion of the value of herd immunity in economic evaluations of vaccines A systematic review of methods used. Vaccine. 2017;35(49 Pt B):6828–41.PubMed

16.

Drake TL, Devine A, Yeung S, Day NP, White LJ, Lubell Y. Dynamic transmission economic evaluation of infectious disease interventions in low- and middle-income countries: a systematic literature review. Health Econ. 2016;25(Suppl 1):124–39.PubMedPubMedCentral

17.

Bhattacharya J, Packalen M. The other ex ante moral hazard in health. J Health Econ. 2012;31(1):135–46.PubMed

18.

Woese CR. A new biology for a new century. Microbiol Mol Biol Rev. 2004;68(2):173–86.PubMedPubMedCentral

19.

Lemoine M, Pradeu T. Dissecting the meanings of “Physiology” to assess the vitality of the discipline. Physiology (Bethesda). 2018;33(4):236–45.PubMed

20.

Benn CS, Netea MG, Selin LK, Aaby P. A small jab—a big effect: nonspecific immunomodulation by vaccines. Trends Immunol. 2013;34(9):431–9.PubMed

21.

Higgins JP, Soares-Weiser K, Lopez-Lopez JA, et al. Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review. BMJ. 2016;355:i5170.PubMedPubMedCentral

22.

Biering-Sørensen S, Aaby P, Lund N. Early BCG-Denmark and neonatal mortality among infants weighing < 2500 g: a randomized controlled trial. Clin Infect Dis. 2017;65(7):1183–90.PubMedPubMedCentral

23.

Arts RJW, Moorlag S, Novakovic B, et al. BCG Vaccination protects against experimental viral infection in humans through the induction of cytokines associated with trained immunity. Cell Host Microbe. 2018;23(1):89–100 e105.

24.

Barnighausen T, Bloom DE, Cafiero-Fonseca ET, O’Brien JC. Valuing vaccination. Proc Natl Acad Sci USA. 2014;111(34):12313–9.PubMed

25.

Ali H, McManus H, O’Connor CC, et al. Human papillomavirus vaccination and genital warts in young Indigenous Australians: national sentinel surveillance data. Med J Aust. 2017;206(5):204–9.PubMed

26.

Moraga-Llop FA. Pneumococcal disease and emergence of serotypes in the vaccine era. Transient trends and serotype replacement. Enferm Infecc Microbiol Clin. 2009;27(1):1–4.PubMed

27.

Guevara M, Ezpeleta C, Gil-Setas A, et al. Reduced incidence of invasive pneumococcal disease after introduction of the 13-valent conjugate vaccine in Navarre, Spain, 2001–2013. Vaccine. 2014;32(22):2553–62.PubMed

28.

Naucler P, Galanis I, Morfeldt E, Darenberg J, Ortqvist A, Henriques-Normark B. Comparison of the impact of pneumococcal conjugate vaccine 10 or pneumococcal conjugate vaccine 13 on invasive pneumococcal disease in equivalent populations. Clin Infect Dis. 2017;65(11):1780–9.PubMedPubMedCentral

29.

Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356(9237):1255–9.PubMed

30.

Saha SK, Darmstadt GL, Baqui AH, et al. Direct detection of the multidrug resistance genome of Haemophilus influenzae in cerebrospinal fluid of children: implications for treatment of meningitis. Pediatr Infect Dis J. 2008;27(1):49–53.PubMed

31.

Painter PR. Supply-demand balance in outward-directed networks and Kleiber’s law. Theor Biol Med Model. 2005;2:45.PubMedPubMedCentral

32.

Clay PG. MTM economics 101: supply vs. demand. J Am Pharm Assoc. 2018;58(2):228–9.

33.

Vassall A, Mangham-Jefferies L, Gomez GB, Pitt C, Foster N. Incorporating demand and supply constraints into economic evaluation in low-income and middle-income countries. Health Econ. 2016;25(Suppl 1):95–115.PubMedPubMedCentral

34.

Curtis V, Cairncross S. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis. 2003;3(5):275–81.PubMed

35.

Canning D, Razzaque A, Driessen J, Walker DG, Streatfield PK, Yunus M. The effect of maternal tetanus immunization on children’s schooling attainment in Matlab, Bangladesh: follow-up of a randomized trial. Soc Sci Med. 2011;72(9):1429–36.PubMed

36.

Llupia A, Garcia-Basteiro AL, Mena G, et al. Vaccination behaviour influences self-report of influenza vaccination status: a cross-sectional study among health care workers. PLoS ONE. 2012;7(7):e39496.PubMedPubMedCentral

37.

Arrossi S, Matos E, Zengarini N, Roth B, Sankaranayananan R, Parkin M. The socio-economic impact of cervical cancer on patients and their families in Argentina, and its influence on radiotherapy compliance. Results from a cross-sectional study. Gynecol Oncol. 2007;105(2):335–40.PubMed

38.

Barnighausen T, Bloom DE, Canning D, et al. Rethinking the benefits and costs of childhood vaccination: the example of the Haemophilus influenzae type b vaccine. Vaccine. 2011;29(13):2371–80.PubMed

39.

Mudrazija S. Work-related opportunity costs of providing unpaid family care in 2013 and 2050. Health Aff (Millwood). 2019;38(6):1003–10.PubMed

40.

Bilcke J, Van Damme P, Beutels P. Cost-effectiveness of rotavirus vaccination: exploring caregiver(s) and “no medical care’’ disease impact in Belgium. Med Decis Making. 2009;29(1):33–50.PubMed

41.

Cai S, Temkin-Greener H. Influenza vaccination and its impact on hospitalization events in nursing homes. J Am Med Dir Assoc. 2011;12(7):493–8.PubMed

42.

Nymark LS. Economic evaluation of the indirect effects of vaccines. The herd immunity effects of vaccines against human transmissible diseases and the non-specific effects of the measles-mumps-rubella and Bacillus Calmette-Guérin vaccines, Aarhus University. Denmark; 2017.

Title: A comprehensive framework for considering additional unintended consequences in economic evaluation
Authors: Liv Nymark
Anna Vassall
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Vaccination
Published in: Cost Effectiveness and Resource Allocation / Issue 1/2020
Electronic ISSN: 1478-7547
DOI: https://doi.org/10.1186/s12962-020-00218-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A comprehensive framework for considering additional unintended consequences in economic evaluation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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