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Vaccines
Special Issues
Health Economics of Vaccines 2.0
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Health Economics of Vaccines 2.0

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 21463

Special Issue Editors

Prof. Dr. Maarten J. Postma

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Guest Editor
Unit of Global Health, Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
Interests: vaccines; global health; health technology assessment; cost-effectiveness; health economics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Cornelis Boersma

E-Mail Website
Guest Editor
Unit of Global Health, Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, 9713 GZ Groningen, The Netherlands
Interests: health economics; health policy; health outcomes; epidemiology; prevention; health systems
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The health economic analysis of vaccines is increasing in importance. In many jurisdictions, cost effectiveness plays an important role in the final decision to include a vaccine into the National Immunization Program. The UK’s Joint Committee of Vaccination and Immunization may serve as an example here. It is often argued that cost effectiveness for vaccines typically differs from that for curative drugs with specificities in the areas of broader economic impacts, indirect effects, spillovers, timing of benefits, and evidence requirements. This Special Issue aims to provide an overview of these aspects from both theoretical and practical (illustrations) angles. Building on our previous Special Issue on health economics, this Special Issue on “Health Economics 2.0” shall expand on these issues and aims to include—in addition to other infections—the first analyses on the cost effectiveness of COVID-19 vaccines.

Prof. Dr. Maarten J. Postma
Dr. Cornelis Boersma
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccines
  • cost effectiveness
  • health economics
  • economic impact
  • economic modeling

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Published Papers (5 papers)

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Research

10 pages, 211 KiB  
Article
Financing of Immunization Programs by Local Government Units in Poland as an Element of Health Policy
by Anna Augustynowicz, Mariola Borowska, Katarzyna Lewtak, Jacek Borowicz, Michał Waszkiewicz, Beata Karakiewicz, Janusz Opolski, Tomasz Banaś and Aleksandra Czerw
Vaccines 2022, 10(1), 28; https://doi.org/10.3390/vaccines10010028 - 27 Dec 2021
Cited by 5 | Viewed by 2888
Abstract
Introduction: The scope and schedule of immunization in Poland is regulated by the Immunization Programme prepared and announced by the State Sanitary Inspector. There are two kinds of vaccines: compulsory vaccines, financed by the state budget at the disposal of the Minister of [...] Read more.
Introduction: The scope and schedule of immunization in Poland is regulated by the Immunization Programme prepared and announced by the State Sanitary Inspector. There are two kinds of vaccines: compulsory vaccines, financed by the state budget at the disposal of the Minister of Health, and vaccines recommended by the central health authorities but financed by local governments within health policy programmes. Compulsory vaccines cover people up to 19 years of age and individuals at higher risk of infections. The public health programmes organized and financed by local governments play an important role in infectious disease control in the country. Objective: The objective of this study is to analyse health policy programmes including immunization programmes, which were developed, implemented and financed by local government units of all levels in Poland between 2016 and 2019. Material and Methods: This analysis covers data compiled by voivodes and submitted to the Minister of Health as annual information on public health tasks carried out by local government units. From the aggregate information, data on all health policy programmes conducted by individual local government units between 2016 and 2019, including immunization, were extracted and analysed. The data were obtained pursuant to the provisions of the act on access to public information. Results: In the analysed period, local government units implemented a total of 1737 health policy programmes that financed the purchase of vaccines, qualification tests for immunization and carrying out immunization by authorized medical entities. Among the vast majority of programmes, promotional activities were also implemented. Conclusions: In Poland, local governments are deeply engaged in the immunization of their citizens by organizing and financing specific health care programmes. These programmes are an essential addition to the state financial resources in infectious disease control. This engagement expresses local government maturity regarding the health needs of the population and public health measures. Communes are the most engaged units among all levels of local governments. It is probably due to close mutual communication between the people and local governments. The growing awareness of the important role of HPV immunization in the prevention of cervical cancer among local government units is reflected in the increase in the number of girls vaccinated against HPV and the increase in financial resources allocated for primary HPV prevention. The decrease in the number of people vaccinated against pneumococci may result from including pneumococcal vaccines in the compulsory immunization schedule. Full article
(This article belongs to the Special Issue Health Economics of Vaccines 2.0)
11 pages, 263 KiB  
Article
Economic Burden of Pneumococcal Disease in Individuals Aged 15 Years and Older in the Liguria Region of Italy
by Matteo Astengo, Chiara Paganino, Daniela Amicizia, Cecilia Trucchi, Federico Tassinari, Camilla Sticchi, Laura Sticchi, Andrea Orsi, Giancarlo Icardi, Maria Francesca Piazza, Bruno Di Silverio, Arijita Deb, Francesca Senese, Gian Marco Prandi and Filippo Ansaldi
Vaccines 2021, 9(12), 1380; https://doi.org/10.3390/vaccines9121380 - 24 Nov 2021
Cited by 4 | Viewed by 1936
Abstract
Despite the availability of vaccines against Streptococcus pneumoniae, the global incidence and economic cost of pneumococcal disease (PD) among adults is still high. This retrospective cohort analysis estimated the cost of emergency department (ED) visits/hospitalizations associated with non-invasive pneumonia and invasive pneumococcal [...] Read more.
Despite the availability of vaccines against Streptococcus pneumoniae, the global incidence and economic cost of pneumococcal disease (PD) among adults is still high. This retrospective cohort analysis estimated the cost of emergency department (ED) visits/hospitalizations associated with non-invasive pneumonia and invasive pneumococcal disease among individuals ≥15 years of age in the Liguria region of Italy during 2012–2018. Data from the Liguria Region Administrative Health Databases and the Ligurian Chronic Condition Data Warehouse were used, including hospital admission date, length of stay, discharge date, outpatient visits, and laboratory/imaging procedures. A ≥30-day gap between two events defined a new episode, and patients with ≥1 ED or inpatient claim for PD were identified. The total mean annual number of hospitalizations for PD was 13,450, costing ~€49 million per year. Pneumonia accounted for the majority of hospitalization costs. The median annual cost of hospitalization for all-cause pneumonia was €38,416,440 (per-capita cost: €26.78) and was €30,353,928 (per-capita cost: €20.88) for pneumococcal and unspecified pneumonia. The total number and associated costs of ED visits/hospitalizations generally increased over the study period. PD still incurs high economic costs in adults in the Liguria region of Italy. Full article
(This article belongs to the Special Issue Health Economics of Vaccines 2.0)
16 pages, 1331 KiB  
Article
Comparing the Clinical and Economic Outcomes Associated with Adjuvanted versus High-Dose Trivalent Influenza Vaccine among Adults Aged ≥ 65 Years in the US during the 2019–20 Influenza Season—A Retrospective Cohort Analysis
by Myron J. Levin, Victoria Divino, Drishti Shah, Mitch DeKoven, Joaquin Mould-Quevedo, Stephen I. Pelton and Maarten J. Postma
Vaccines 2021, 9(10), 1146; https://doi.org/10.3390/vaccines9101146 - 8 Oct 2021
Cited by 12 | Viewed by 2899
Abstract
The burden of influenza is disproportionally higher among older adults. We evaluated the relative vaccine effectiveness (rVE) of adjuvanted trivalent (aIIV3) compared to high-dose trivalent influenza vaccine (HD-IIV3e) against influenza and cardio-respiratory disease (CRD)-related hospitalizations/ER visits among adults ≥65 years during the 2019–2020 [...] Read more.
The burden of influenza is disproportionally higher among older adults. We evaluated the relative vaccine effectiveness (rVE) of adjuvanted trivalent (aIIV3) compared to high-dose trivalent influenza vaccine (HD-IIV3e) against influenza and cardio-respiratory disease (CRD)-related hospitalizations/ER visits among adults ≥65 years during the 2019–2020 influenza season. Economic outcomes were also compared. A retrospective cohort analysis was conducted using prescription, professional fee claims, and hospital data. Inverse probability of treatment weighting (IPTW) was used to adjust for confounding. IPTW-adjusted Poisson regression was used to evaluate the adjusted rVE of aIIV3 versus HD-IIV3e. All-cause and influenza-related healthcare resource utilization (HCRU) and costs were examined post-IPTW. Recycled predictions from generalized linear models were used to estimate adjusted costs. Adjusted analysis showed that aIIV3 (n = 798,987) was similarly effective compared to HD-IIV3e (n = 1,655,979) in preventing influenza-related hospitalizations/ER visits (rVE 3.1%; 95% CI: −2.8%; 8.6%), hospitalizations due to any cause (−0.7%; 95% CI: −1.6%; 0.3%), and any CRD-related hospitalization/ER visit (0.9%; 95% CI: 0.01%; 1.7%). Adjusted HCRU and annualized costs were also statistically insignificant between the two cohorts. The adjusted clinical and economic outcomes evaluated in this study were comparable between aIIV3 and HD-IIV3e during the 2019–2020 influenza season. Full article
(This article belongs to the Special Issue Health Economics of Vaccines 2.0)
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9 pages, 223 KiB  
Article
Economic Assessment of High-Dose Versus Adjuvanted Influenza Vaccine: An Evaluation of Hospitalization Costs Based on a Cohort Study
by Robertus van Aalst, Stefan Gravenstein, Vincent Mor, Salaheddin M. Mahmud, Jan Wilschut, Maarten Postma and Ayman Chit
Vaccines 2021, 9(10), 1065; https://doi.org/10.3390/vaccines9101065 - 24 Sep 2021
Cited by 3 | Viewed by 2936
Abstract
Two influenza vaccines are licensed in the U.S. exclusively for the 65 years and older population: a trivalent inactivated high-dose influenza vaccine (HD-IIV3) and a trivalent inactivated adjuvanted influenza vaccine (aIIV3). In a recent publication, we estimated a relative vaccine effectiveness (rVE) of [...] Read more.
Two influenza vaccines are licensed in the U.S. exclusively for the 65 years and older population: a trivalent inactivated high-dose influenza vaccine (HD-IIV3) and a trivalent inactivated adjuvanted influenza vaccine (aIIV3). In a recent publication, we estimated a relative vaccine effectiveness (rVE) of HD-IIV3 vs. aIIV3 of 12% (95% CI: 3.3–20%) for influenza-related hospitalizations using a retrospective study design, but did not report the number of prevented hospitalizations nor the associated avoided cost. In this paper we report estimations for both. Methods: Leveraging the rVE of a cohort study over two influenza seasons (2016/17 and 2017/18), we collected cost data for healthcare provided to the same study population. Vaccine costs were obtained from the Medicare pricing schedule. Our economic assessment compared cost of vaccination and hospital care for patients experiencing acute respiratory or cardiovascular illness. Results: We analyzed 1.9 million HD-IIV3 and 223,793 aIIV3 recipients. Average vaccine list prices were $46.23 for HD-IIV3 and $48.26 for aIIV3. The hospitalization rates for respiratory disease in HD-IIV3 and aIIV3 recipients were 187 (95% CI: 185–189) and 212 (195–231) per 10,000 persons-years, respectively. Attributing the average cost per hospitalization of $12,652 ($12,214–$13,090) to the difference in hospitalization rates, we estimate net savings of HD-IIV3 to be $34 ($10–$62) per recipient. Conclusion: Pooled over two predominantly A/H3N2 respiratory seasons, vaccination with HD-IIV3 was associated with lower hospitalization rates and associated costs compared to aIIV3 in senior members of a large national managed health care company in the U.S. Reduced hospitalizations affect healthcare utilization overall, and therefore other costly health outcomes. Full article
(This article belongs to the Special Issue Health Economics of Vaccines 2.0)
19 pages, 2573 KiB  
Article
COVID-19 Vaccination Scenarios: A Cost-Effectiveness Analysis for Turkey
by Arnold Hagens, Ahmet Çağkan İnkaya, Kasirga Yildirak, Mesut Sancar, Jurjen van der Schans, Aylin Acar Sancar, Serhat Ünal, Maarten Postma and Selen Yeğenoğlu
Vaccines 2021, 9(4), 399; https://doi.org/10.3390/vaccines9040399 - 18 Apr 2021
Cited by 37 | Viewed by 9748
Abstract
As of March 2021, COVID-19 has claimed the lives of more than 2.7 million people worldwide. Vaccination has started in most countries around the world. In this study, we estimated the cost-effectiveness of strategies for COVID-19 vaccination for Turkey compared to a baseline [...] Read more.
As of March 2021, COVID-19 has claimed the lives of more than 2.7 million people worldwide. Vaccination has started in most countries around the world. In this study, we estimated the cost-effectiveness of strategies for COVID-19 vaccination for Turkey compared to a baseline in the absence of vaccination and imposed measures by using an enhanced SIRD (Susceptible, Infectious, Recovered, Death) model and various scenarios for the first year after vaccination. The results showed that vaccination is cost-effective from a health care perspective, with an incremental cost-effectiveness ratio (ICER) of 511 USD/QALY and 1045 USD/QALY if vaccine effectiveness on transmission is equal or reduced to only 50% of effectiveness on disease, respectively, at the 90% baseline effectiveness of the vaccine. From a societal perspective, cost savings were estimated for both scenarios. Other results further showed that the minimum required vaccine uptake to be cost-effective would be at least 30%. Sensitivity and scenario analyses, as well as the iso-ICER curves, showed that the results were quite robust and that major changes in cost-effectiveness outcomes cannot be expected. We can conclude that COVID-19 vaccination in Turkey is highly cost-effective or even cost-saving. Full article
(This article belongs to the Special Issue Health Economics of Vaccines 2.0)
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