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Sarker AR. Economic assessment of childhood rotavirus vaccination in Bangladesh. J Infect Public Health 2023; 16:816-822. [PMID: 37003027 DOI: 10.1016/j.jiph.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/06/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Rotavirus is one of the most highly prevalent communicable diseases in Bangladesh. The objective of this study is to evaluate the benefit-cost ratio of childhood rotavirus vaccination program in Bangladesh. A spreadsheet-based model was used to estimate the benefit and cost of a nationwide universal rotavirus vaccination program against rotavirus infections among under-five children in Bangladesh. A benefit-cost analysis was performed to evaluate a universal vaccination program compared with a status quo. Data from various published vaccination-related studies and public reports were used. The introduction of a childhood rotavirus vaccination program in Bangladesh for 14.78 million under-five children is projected to prevent approximately 1.54 million rotavirus cases during the first 2 years including 0.7 million severe rotavirus infections. This study shows that among the WHO-prequalified rotavirus vaccines, the net societal benefit is the highest if the vaccination program adopts ROTAVAC® rather than Rotarix® or ROTASIIL®. For every dollar invested in the outreach-based ROTAVAC® vaccination program, society would gain $2.03 in return, while in a facility-based vaccination program, society would gain up to about $2.2. The findings of this study demonstrate that a universal childhood rotavirus vaccination program is a cost-beneficial investment of public money. Thus, the government should consider the introduction of rotavirus vaccination in their Expanded Program on Immunization since the rotavirus immunization policy in Bangladesh will be economically justifiable.
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Affiliation(s)
- Abdur Razzaque Sarker
- Health Economics and Financing Research, Population Studies Division, Bangladesh Institute of Development Studies (BIDS), Agargaon, Dhaka 1207, Bangladesh.
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Lopes JM, Morales CC, Alvarado M, Melo VAZC, Paiva LB, Dias EM, Pardalos PM. Optimization methods for large-scale vaccine supply chains: a rapid review. ANNALS OF OPERATIONS RESEARCH 2022; 316:699-721. [PMID: 35531563 PMCID: PMC9059697 DOI: 10.1007/s10479-022-04720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 05/15/2023]
Abstract
Global vaccine revenues are projected at $59.2 billion, yet large-scale vaccine distribution remains challenging for many diseases in countries around the world. Poor management of the vaccine supply chain can lead to a disease outbreak, or at worst, a pandemic. Fortunately, a large number of those challenges, such as decision-making for optimal allocation of resources, vaccination strategy, inventory management, among others, can be improved through optimization approaches. This work aims to understand how optimization has been applied to vaccine supply chain and logistics. To achieve this, we conducted a rapid review and searched for peer-reviewed journal articles, published between 2009 and March 2020, in four scientific databases. The search resulted in 345 articles, of which 25 unique studies met our inclusion criteria. Our analysis focused on the identification of article characteristics such as research objectives, vaccine supply chain stage addressed, the optimization method used, whether outbreak scenarios were considered, among others. Approximately 64% of the studies dealt with vaccination strategy, and the remainder dealt with logistics and inventory management. Only one addressed market competition (4%). There were 14 different types of optimization methods used, but control theory, linear programming, mathematical model and mixed integer programming were the most common (12% each). Uncertainties were considered in the models of 44% of the studies. One resulting observation was the lack of studies using optimization for vaccine inventory management and logistics. The results provide an understanding of how optimization models have been used to address challenges in large-scale vaccine supply chains.
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Affiliation(s)
- Juliano Marçal Lopes
- Gaesi, Departament of Electric Energy and Automation Engineering, Polytechnic School, University of São Paulo, São Paulo, SP Brazil
| | - Coralys Colon Morales
- HEALTH-Engine Laboratory, Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL USA
| | - Michelle Alvarado
- HEALTH-Engine Laboratory, Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL USA
| | - Vidal Augusto Z. C. Melo
- Gaesi, Departament of Electric Energy and Automation Engineering, Polytechnic School, University of São Paulo, São Paulo, SP Brazil
| | - Leonardo Batista Paiva
- Gaesi, Departament of Electric Energy and Automation Engineering, Polytechnic School, University of São Paulo, São Paulo, SP Brazil
| | - Eduardo Mario Dias
- Gaesi, Departament of Electric Energy and Automation Engineering, Polytechnic School, University of São Paulo, São Paulo, SP Brazil
| | - Panos M. Pardalos
- HEALTH-Engine Laboratory, Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL USA
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Yuasa A, Yonemoto N, LoPresti M, Ikeda S. Productivity loss/gain in cost-effectiveness analyses for vaccines: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2021; 21:235-245. [PMID: 33593223 DOI: 10.1080/14737167.2021.1881484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: The kinds of costs included in cost-effectiveness analyses (CEAs) for vaccines, such as direct medical costs and indirect costs, may affect their outcomes. While some guidelines recommend inclusion of costs associated with productivity losses/gains, very little guidance is provided about the productivity elements to include and their calculation approach.Areas covered: We conducted a systematic review of CEAs for vaccines and vaccine programs published between 1 January 2010 and 19 November 2019 that included productivity costs using Medline, Embase, and the Cochrane Library. The kind of productivity elements included their calculation approach, and the impact of their inclusion on cost-effectiveness are summarized. Among 88 studies identified, productivity elements included were reported for 71 studies (81%) with absenteeism being the most commonly included element. Only 24 studies (27%) reported the approach used to calculate productivity costs (human capital vs. friction approach). Most studies (81%) reported a more favorable cost-effectiveness with the inclusion of productivity losses/gains.Expert opinion: Inclusion of productivity losses/gains for CEAs for vaccines has resulted in more favorable cost-effectiveness based on the studies reviewed. However, clearer guidance on the productivity elements to include by disease area and more transparency on the calculation method used may be needed.
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Affiliation(s)
- Akira Yuasa
- Pfizer Japan Inc., Tokyo, Japan.,Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | | | | | - Shunya Ikeda
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
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Mathijssen DAR, Heisen M, Clark-Wright JF, Wolfson LJ, Lu X, Carrol S, van Dijk BCP, Klijn SL, Alemayehu B. Budget impact analysis of introducing a non-reconstituted, hexavalent vaccine for pediatric immunization in the United Kingdom. Expert Rev Vaccines 2021; 19:1167-1175. [PMID: 33455489 DOI: 10.1080/14760584.2020.1873770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objectives: Non-reconstituted, hexavalent vaccines (HV-NRs) can facilitate clinical practice by shortening vaccine preparation and administration time and by reducing the risk of vaccination errors compared to combination vaccines requiring reconstitution. The aim of this study was to determine the budget impact of introducing an HV-NR into the United Kingdom's (UK) pediatric immunization program, which currently uses a hexavalent vaccine requiring reconstitution (HV-R). Methods: Abudget impact model covering a 10-year time horizon was developed. The target population constituted closed UK birth cohorts from 2020 to 2029. Total direct costs from the payer's perspective consisted of four main categories: vaccine acquisition and management, healthcare provider's service provision, (non-)contaminated needle-stick and sharps injury (NSI), and non-NSI vaccination error costs. The net budget impact was calculated by comparing the costs in two different market share scenarios. Results: The use of HV-NR instead of HV-R was estimated to save £9,079,927 over a 10-year time horizon (i.e. £907,993 per year). Assuming all other vaccine criteria are equivalent the budget impact was most sensitive to changes in time spent by the healthcare provider and management costs. Conclusion: Results suggest, introducing an HV-NR into the UK's pediatric immunization program is potentially cost saving for the healthcare system.
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Affiliation(s)
| | - M Heisen
- Pharmerit - an OPEN health company , Rotterdam, The Netherlands
| | | | | | - X Lu
- Merck & Co., Inc ., Kenilworth, NJ, USA
| | - S Carrol
- Sanofi Pasteur UK & Ireland , Reading, United Kingdom
| | - B C P van Dijk
- Pharmerit - an OPEN health company , Rotterdam, The Netherlands
| | - S L Klijn
- Pharmerit - an OPEN health company , Rotterdam, The Netherlands
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Fens T, Zhou G, Postma MJ, van Puijenbroek EP, van Boven JFM. Economic evaluations of chronic obstructive pulmonary disease pharmacotherapy: how well are the real-world issues of medication adherence, comorbidities and adverse drug-reactions addressed? Expert Opin Pharmacother 2021; 22:923-935. [PMID: 33435700 DOI: 10.1080/14656566.2021.1873953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION When estimating the cost-effectiveness or budget impact of chronic obstructive pulmonary disease (COPD) medication, it is common practice to use trial data for clinical inputs. However, such inputs do not always reflect the real-world situation. Previous reviews recognized the need for taking real-world data (medication adherence, comorbidity and adverse drug reactions [ADRs]) into account. Whether recent cost-effectiveness analyses of COPD medication implemented those recommendations is unknown. AREAS COVERED The authors reviewed recent economic evaluations of COPD-maintenance treatments focusing on medication adherence, comorbidity and ADRs. EXPERT OPINION In most registration trials of COPD treatment, strict inclusion and exclusion criteria are applied. During trials, patient monitoring is well controlled. As such, medication adherence is often higher than seen in less controlled, real-world environments with more heterogeneous characteristics. Additionally, safety data collected in trials may not be widely generalizable due to more comorbidity and polypharmacy in the real-world. Consequently, when merely relying on trial data, the impact of adherence, comorbidity and ADRs on the cost-effectiveness can be underestimated. To overcome these real-world data gaps, use of pragmatic trials and observational studies in addition to strictly controlled trial data is recommended. To catalyze implementation of these real-world issues, reporting checklists should be updated.
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Affiliation(s)
- Tanja Fens
- University of Groningen, Groningen Research Institute of Pharmacy, Groningen, The Netherlands.,Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Guiling Zhou
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maarten J Postma
- University of Groningen, Groningen Research Institute of Pharmacy, Groningen, The Netherlands.,Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Institute of Science in Healthy Aging & healthcaRE (SHARE), Groningen, The Netherlands.,Faculty of Economics & Business, Department of Economics, Econometrics & Finance, University of Groningen, Groningen, The Netherlands
| | - Eugène P van Puijenbroek
- University of Groningen, Groningen Research Institute of Pharmacy, Groningen, The Netherlands.,Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, MH, The Netherlands.,Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Job F M van Boven
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.,Medication Adherence Expertise Center of the Northern Netherlands (MAECON), Groningen, The Netherlands
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Graham J, Wolfson LJ, Kyle J, Bolde-Villarreal CP, Guarneros-DeRegil DB, Monsanto H, Pillsbury M, Talbird S, Daniels VJ. Budget impact analysis of multiple varicella vaccination strategies: a Mexico perspective. Hum Vaccin Immunother 2019; 16:886-894. [PMID: 31567045 PMCID: PMC7227656 DOI: 10.1080/21645515.2019.1672491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
A number of live-attenuated varicella vaccines are produced globally that provide protection against the varicella zoster virus. In Mexico, varicella vaccination is not included in the national immunization program and is recommended for use only in high-risk subgroups. We developed a budget impact model to estimate the impact of universal childhood immunization against varicella on the national payer system in Mexico. A scenario of no varicella vaccination was compared to scenarios with vaccination with a single dose at 13 months of age, in alignment with the existing program of immunization with the measles-mumps-rubella vaccine. Nine different vaccination scenarios were envisioned, differing by vaccine type and by coverage. Varicella cases and treatment costs of each scenario were computed in a dynamic transmission model of varicella epidemiology, calibrated to the population of Mexico. Unit costs were based on Mexico sources or were from the literature. The results indicated that each of the three vaccine types increased vaccine acquisition and administration expenditures but produced overall cost savings in each of the first 10 years of the program, due to fewer cases and reduced varicella treatment costs. A highly effective vaccine at 95% coverage produced the greatest cost savings.
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Affiliation(s)
- Jonathan Graham
- Health Economics, Research Triangle Park, RTI Health Solutions, NC, USA
| | - Lara J Wolfson
- Center for Observational and Real World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA
| | - Jeffrey Kyle
- Center for Observational and Real World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA
| | | | | | | | - Matthew Pillsbury
- Center for Observational and Real World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA
| | - Sandra Talbird
- Health Economics, Research Triangle Park, RTI Health Solutions, NC, USA
| | - Vincent J Daniels
- Center for Observational and Real World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA
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