Informing decision makers seeking to improve vaccination programs: case-study Serbia.

Autor: Sauboin C; Health Economics Department, GSK, Wavre, Belgium.; Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.; Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands., Mihajlović J; Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.; Mihajlović Health Analytics (Miha), Novi Sad, Serbia., Postma MJ; Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.; Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands., Geets R; Health Economics Department, GSK, Wavre, Belgium., Antic D; Pharma Research & Development, GSK, Beograd, Serbia., Standaert B; Health Economics Department, GSK, Wavre, Belgium.
Jazyk: angličtina
Zdroj: Journal of market access & health policy [J Mark Access Health Policy] 2021 Jul 25; Vol. 9 (1), pp. 1938894. Date of Electronic Publication: 2021 Jul 25 (Print Publication: 2021).
DOI: 10.1080/20016689.2021.1938894
Abstrakt: Background: The optimisation of vaccine policies before their implementation is beholden upon public health decision makers, seeking to maximise population health. In this case study in Serbia, the childhood vaccines under consideration included pneumococcal conjugate vaccination (PCV), rotavirus (RV) vaccination and varicella zoster virus (VZV) vaccination. Objective: The objective of this study is to define the optimal order of introduction of vaccines to minimise deaths, quality adjusted life years (QALYs) lost, or hospitalisation days, under budget and vaccine coverage constraints. Methods: A constrained optimisation model was developed including a static multi-cohort decision-tree model for the three infectious diseases. Budget and vaccine coverage were constrained, and to rank the vaccines, the optimal solution to the linear programming problem was based upon the ratio of the outcome (deaths, QALYs or hospitalisation days) per unit of budget. A probabilistic decision analysis Monte Carlo simulation technique was used to test the robustness of the rankings. Results: PCV was the vaccine ranked first to minimise deaths, VZV vaccination for QALY loss minimisation and RV vaccination for hospitalisation day reduction. Sensitivity analysis demonstrated the most robust ranking was that for PCV minimizing deaths. Conclusion: Constrained optimisation modelling, whilst considering all potential interventions currently, provided a comprehensive and rational approach to decision making.
Competing Interests: BS, DA, RG and CS were working for the GSK group of companies at the time of the research. BS and RG hold shares of the GSK group of companies. CS was holding shares of the GSK group of companies. JM is employed by MiHA; his institution received consulting fees from the GSK group of companies inside and outside this submitted work. MJP received grants and honoraria from various pharmaceutical companies, inclusive of all major companies developing, producing, and marketing vaccines; and received grants from Indonesian government and various non-profit organisations (WHO and EU) outside of submitted work. MJP also holds stocks, shares and advisorships in different consultancy companies. The University and consultancies where MJP is involved are also consortium members in various Innovative Medicines Initiative (IMI) projects. All authors declare no other financial and non-financial relationships and activities.
(© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)
Databáze: MEDLINE
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