Vaccine decision making should be transparent and more consistent, say experts

30 Dec 2019
Vaccine decision making should be transparent and more consistent, say experts

A panel of experts is advocating that wider benefits should consistently be included when making decisions about introducing new vaccines and that decision making should be as transparent as possible.

The paper Economic Evaluation of Meningococcal Vaccines: Considerations for the Future was published in the European Journal of Health Economics and reflects the views of a panel of experts in health economic evaluation and meningococcal disease.  Experts were convened to discuss a report written by the Office of Health Economics in collaboration with Meningitis Research Foundation and commissioned and funded by Pfizer.  The report analysed published cost effectiveness studies on meningococcal vaccines and found considerable variability in vaccine decision making processes amongst different countries.

Meningococcal disease is a severe but relatively uncommon illness which kills one in ten of those affected and leaves one in ten of people who survive with a diverse set of life altering impairments. The diverse range of after effects means that it is hard to quantify health loss associated with the disease.  Babies and children under the age of five are at the highest risk of disease but the tools used to measure the impact of diseases are not suitable for this age group. 

We recommend a more sophisticated analysis of the benefits of meningococcal vaccine - Linda Glennie, Director of Research, MRF

Whilst policymakers across different countries often consider factors such as clinical outcomes and disease burden, the ways in which these are measured differ substantially between studies and are not always transparent.  Also relatively few decision making processes place any importance on equity or impact on carers, and none consider the peace of mind resulting from vaccination.  Experts also found that the unpredictability of meningococcal disease made it harder to measure the full range of benefits gained from preventing it.

There is a need for further discussion about improving the valuation of health loss in children and how we can account for public preference when decision making bodies such as the UK’s Joint Committee on Vaccination and Immunisation consider the cost effectiveness of vaccines, say disease experts.

Linda Glennie, Director of Research at MRF said: “We recommend a more sophisticated analysis of the benefits of meningococcal vaccines when considering whether to include them in the programme. When deciding which vaccines should be funded, in order to make consistent, transparent and fair decisions, a core set of principles could be developed with extra criteria varying among countries as long as the process is transparent. 

“Quantifying the health benefits gained from preventing meningococcal disease is complex.  Further consideration is needed of how we can adequately value vaccines which prevent rare, severe childhood illness and how we can incorporate public preference and other benefits of vaccination such as peace of mind into the analysis. Continuing to ignore these factors will lead to an incomplete analysis of the benefits of immunisation against all diseases and particularly meningococcal disease.”

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