Economic evaluation of combination vaccines: Enabling a more comprehensive assessment of their benefits and...

Even though two widely used combination vaccines (measles-rubella- and diphtheria- tetanus-pertussis-containing vaccines) are universally acknowledged as the cornerstones of pediatric immunization programs, the development of new combination vaccines for children has not been a priority for manufacturers, policy bodies, or decision-makers. At the same time, economic evaluations have not assessed the full array of benefits and risks associated with combination vaccines. As part of an effort to identify and prioritize potential new combination vaccines, we aimed to enhance efforts to establish their value, a crucial step toward a more thorough, quantifiable, and realistic assessment of these vaccines. We reviewed the literature on economic evaluations of combination vaccines to more precisely identify and define current gaps in value assessment. We identified a set of (often unvalued) benefits and risks and created a list of value drivers and metrics for potential inclusion in future evaluations. Value drivers were then categorized based on how they resonate with decision-makers' priorities and their contribution to product value. Metrics were categorized based on their quantifiability and their fit within existing economic evaluation frameworks. We developed a prioritized checklist of value drivers and metrics to assess combination vaccines through a consultative process involving numerous immunization stakeholders (e.g., immunization specialists, regional immunization advisors, policy bodies). The checklist was further refined through a convening of health economics experts and ultimately endorsed by the World Health Organization's Immunization and Vaccines-related Implementation Research Advisory Committee. This checklist of prioritized value drivers and metrics is meant to serve as a tool for analysts to value combination vaccines and help ensure these vaccines are more comprehensively assessed by decision-makers to inform investment decisions or adoption.