The impact of current infection levels on the cost-benefit of vaccination
When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; curr...
Ausführliche Beschreibung
Autor*in: |
Matt J. Keeling [verfasserIn] Katherine A. Broadfoot [verfasserIn] Samik Datta [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2017 |
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Schlagwörter: |
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Übergeordnetes Werk: |
In: Epidemics - Elsevier, 2015, 21(2017), C, Seite 56-62 |
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Übergeordnetes Werk: |
volume:21 ; year:2017 ; number:C ; pages:56-62 |
Links: |
Link aufrufen |
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DOI / URN: |
10.1016/j.epidem.2017.06.004 |
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Katalog-ID: |
DOAJ046956506 |
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520 | |a When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. | ||
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10.1016/j.epidem.2017.06.004 doi (DE-627)DOAJ046956506 (DE-599)DOAJ34d01634106e4cdd90c7828cd951d546 DE-627 ger DE-627 rakwb eng RC109-216 Matt J. Keeling verfasserin aut The impact of current infection levels on the cost-benefit of vaccination 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. Vaccination Health economics QALY Damped oscillations Infectious and parasitic diseases Katherine A. Broadfoot verfasserin aut Samik Datta verfasserin aut In Epidemics Elsevier, 2015 21(2017), C, Seite 56-62 (DE-627)587142170 (DE-600)2467993-8 18780067 nnns volume:21 year:2017 number:C pages:56-62 https://doi.org/10.1016/j.epidem.2017.06.004 kostenfrei https://doaj.org/article/34d01634106e4cdd90c7828cd951d546 kostenfrei http://www.sciencedirect.com/science/article/pii/S1755436516300706 kostenfrei https://doaj.org/toc/1755-4365 Journal toc kostenfrei https://doaj.org/toc/1878-0067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 21 2017 C 56-62 |
spelling |
10.1016/j.epidem.2017.06.004 doi (DE-627)DOAJ046956506 (DE-599)DOAJ34d01634106e4cdd90c7828cd951d546 DE-627 ger DE-627 rakwb eng RC109-216 Matt J. Keeling verfasserin aut The impact of current infection levels on the cost-benefit of vaccination 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. Vaccination Health economics QALY Damped oscillations Infectious and parasitic diseases Katherine A. Broadfoot verfasserin aut Samik Datta verfasserin aut In Epidemics Elsevier, 2015 21(2017), C, Seite 56-62 (DE-627)587142170 (DE-600)2467993-8 18780067 nnns volume:21 year:2017 number:C pages:56-62 https://doi.org/10.1016/j.epidem.2017.06.004 kostenfrei https://doaj.org/article/34d01634106e4cdd90c7828cd951d546 kostenfrei http://www.sciencedirect.com/science/article/pii/S1755436516300706 kostenfrei https://doaj.org/toc/1755-4365 Journal toc kostenfrei https://doaj.org/toc/1878-0067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 21 2017 C 56-62 |
allfields_unstemmed |
10.1016/j.epidem.2017.06.004 doi (DE-627)DOAJ046956506 (DE-599)DOAJ34d01634106e4cdd90c7828cd951d546 DE-627 ger DE-627 rakwb eng RC109-216 Matt J. Keeling verfasserin aut The impact of current infection levels on the cost-benefit of vaccination 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. Vaccination Health economics QALY Damped oscillations Infectious and parasitic diseases Katherine A. Broadfoot verfasserin aut Samik Datta verfasserin aut In Epidemics Elsevier, 2015 21(2017), C, Seite 56-62 (DE-627)587142170 (DE-600)2467993-8 18780067 nnns volume:21 year:2017 number:C pages:56-62 https://doi.org/10.1016/j.epidem.2017.06.004 kostenfrei https://doaj.org/article/34d01634106e4cdd90c7828cd951d546 kostenfrei http://www.sciencedirect.com/science/article/pii/S1755436516300706 kostenfrei https://doaj.org/toc/1755-4365 Journal toc kostenfrei https://doaj.org/toc/1878-0067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 21 2017 C 56-62 |
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10.1016/j.epidem.2017.06.004 doi (DE-627)DOAJ046956506 (DE-599)DOAJ34d01634106e4cdd90c7828cd951d546 DE-627 ger DE-627 rakwb eng RC109-216 Matt J. Keeling verfasserin aut The impact of current infection levels on the cost-benefit of vaccination 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. Vaccination Health economics QALY Damped oscillations Infectious and parasitic diseases Katherine A. Broadfoot verfasserin aut Samik Datta verfasserin aut In Epidemics Elsevier, 2015 21(2017), C, Seite 56-62 (DE-627)587142170 (DE-600)2467993-8 18780067 nnns volume:21 year:2017 number:C pages:56-62 https://doi.org/10.1016/j.epidem.2017.06.004 kostenfrei https://doaj.org/article/34d01634106e4cdd90c7828cd951d546 kostenfrei http://www.sciencedirect.com/science/article/pii/S1755436516300706 kostenfrei https://doaj.org/toc/1755-4365 Journal toc kostenfrei https://doaj.org/toc/1878-0067 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2112 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 21 2017 C 56-62 |
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Matt J. Keeling misc RC109-216 misc Vaccination misc Health economics misc QALY misc Damped oscillations misc Infectious and parasitic diseases The impact of current infection levels on the cost-benefit of vaccination |
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RC109-216 The impact of current infection levels on the cost-benefit of vaccination Vaccination Health economics QALY Damped oscillations |
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impact of current infection levels on the cost-benefit of vaccination |
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The impact of current infection levels on the cost-benefit of vaccination |
abstract |
When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. |
abstractGer |
When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. |
abstract_unstemmed |
When considering a new vaccine programme or modifying an existing one, economic cost-benefit analysis, underpinned by predictive epidemiological modelling, is a key component. This analysis is intimately linked to the willingness to pay for additional QALYs (quality-adjusted life-years) gained; currently in England and Wales a health programme is economically viable if the cost per QALY gained is less than £ 20,000, and models are often used to assess if a vaccine programme is likely to fall below this threshold cost. Before a programme begins, infection levels are generally high and therefore vaccination may be expected to have substantial effects and therefore will often be economically viable. However, once a programme is established, and infection rates are lower, it might be expected that a re-evaluation of the programme (using current incidence information) will show it to be less cost-effective. This is the scenario we examine here with analytical tools and simple ODE models. Surprisingly we show that in most cases the benefits from maintaining an existing vaccination programme are at least equal to those of starting the programme initially, and in the majority of scenarios the differences between the two are minimal. In practical terms, this is an extremely helpful finding, allowing us to assert that the action of immunising individuals does not de-value the vaccination programme. |
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