Why is this important
When policy makers need to make decisions about healthcare and which treatments and vaccinations will be made available to the public, they use cost-effectiveness analyses as part of the process.
Cost-effectiveness analyses compare the cost of doing something (such as vaccinating all children routinely against a particular disease in the UK) with how much benefit you get from doing it (such as health gains through preventing disease). In healthcare, benefit is often measured using ‘QALYs’ or quality adjusted life years, which is a summary measure combining how long people live but also what their quality of life is. At the moment in cost-effectiveness analyses these QALYs are assumed to be valued equally, so a QALY gained by a child has the same value as a QALY gained by an older person. This also means that one QALY gained by one child is the same as ten children gaining 10% of a QALY. This matters because if people would actually rather protect children against rare, but very serious diseases compared to very common, mild ones then this should be taken into account in the decision making and it may mean policy makers prioritise different vaccines. Whether QALYs should be weighted is often discussed in policy debates about introducing vaccines, particularly so in the recent debates over the use of Bexsero® against MenB meningococcal disease. However, it is not currently done, in part due to lack of evidence of how QALYs should be weighted.