Vortragssitzung
Ökonomik der Pandemie 1
Vorträge
Capturing the Value of Vaccination within health technology assessment and health economics - Literature review and novel conceptual framework
Jürgen Wasem, Universität Duisburg-Essen
Einleitung / Introduction
Vaccination can be a cost-effective means to reduce morbidity and mortality, and decisions on adoption of a vaccine usually consider disease burden, efficacy/effectiveness, safety and cost-effectiveness as part of a health technology assessment (HTA) or cost-effectiveness analysis (CEA). However, these factors cover only part of the potential benefits of vaccination. The objective of this project was to understand how the value of vaccination (VoV) can be more broadly captured in HTA.
Methode / Method
A targeted literature review was conducted in Medline in October 2020 for English-language vaccine studies presenting a VoV framework. No restrictions were applied for population, comparator, geographical scope, timeframe or study design. In addition, Google Scholar and key international and national health/vaccination websites were searched. The types of frameworks presented in the literature were assessed.
Ergebnisse / Results
Of the 6,661 abstracts identified and screened, 278 full-text articles were reviewed, and 24 relevant studies included. An additional 20 studies were included from website searching. Of the 44 studies included in the review, 26 described frameworks and their value concepts/elements, while 18 described individual value concepts/elements. The analyses of the identified framework studies identified three dimensions: • Dimension 1 included standard concepts and elements captured in current economic modelling practices, using utilities for health benefits and costs, from a healthcare payer perspective. Health gains to vaccinated individuals and healthcare cost-savings were typically included. • Dimension 2 included conventional concepts and elements, captured within a societal perspective in economic evaluation. Conventional concepts were defined as well-known, with an established methodology for measurement, and/or impacting Quality Adjustd Life Years or costs. Productivity gains to patients and caregivers were typically included. • Dimension 3 included unconventional concepts and elements, from a societal perspective. Unconventional concepts were by definition difficult to capture or measure, and may only be described qualitatively at present as methods for their quantification are yet to be developed or validated. Other productivity gains, community and health system benefits and macroeconomic benefits were typically included.
Zusammenfassung / Conclusion
Current economic evaluations tend to consider a narrow set of benefits such as individual health gains, healthcare cost-savings and productivity gains. This study gives an overview on approaches to broaden the scope of HTA for vaccines. However, it is crucial to be able to move from concept to data, if want to be able to capture the full benefits of vaccination.
AutorInnen
Jürgen Wasem, Universität Duisburg-Essen
Ekkehard Beck, GSK, Wavre, Belgium
Eliana Biundo, GSK, Wavre, Belgium
Mark Doherty, GSK, Wavre, Belgium
Antonio J Garcia-Ruiz, University of Malaga, Malaga, Spain
Maarten Postma, Univerity of Groeningen, Groeningen, Netherlands
Beata Smela, Creativ-Ceutical, Cracow, Poland
Mondher Toumi, Creativ Ceutical, Luxembourg
Terry Nolan, University of Melbourne, Melbourne, Australia
David Salisbury, Programme for Global Health, Royal Institute of International Affairs, Chathman House, London, United Kingdom
Jumping the queue. Willingness to pay for faster access to COVID-19 vaccines in seven European countries
Sebastian Neumann-Böhme, Hamburg Center for Health Economics, Universität Hamburg
Einleitung / Introduction
Once the first vaccines against COVID-19 were approved by regulators, many countries set up priority lists to manage the demand for the limited number of vaccines available. The aim of our study is to estimate the willingness to pay for a COVID-19 vaccine, or more specifically, quicker access to this vaccine in seven European countries in January 2021 and investigate what influenced the willingness to pay. The ECOS data allows us to investigate the determinants of the willingness to pay as well as other aspects such as the behavioural factors associated with the demand for access to a COVID-19 vaccine
Methode / Method
We report data from the European COVID Survey (ECOS) consisting of representative samples of the population from Denmark, France, Germany, Italy, Portugal, the Netherlands, and the UK (N=7,068) in terms of age, gender, regional distribution and education. The data presented here consists of the fifth ECOS data collection conducted from January 19 until February 1, 2021. We elicited the willingness to pay for access to two hypothetical COVID-19 vaccines (100% and 60% effective). Respondents were asked how much they would be willing to pay to get an immediate COVID-19 vaccination rather than to wait for a free offer through the public system. By using this method as opposed to just eliciting the willingness to pay, we avoid the dominant no treatment effect methodologically and practically the problem that in the ECOS countries, citizens never directly faced the cost of the vaccine since it was paid for by national governments. Willingness to pay values were elicited with a modified version of the payment scale, adjusted for the country purchasing powers and converted into Euros (in the case of Denmark and the UK)
Ergebnisse / Results
Respondents gave mean willingness to pay of 54.96 Euros (median 37 Euros) for access to a hypothetical 100% effective COVID-19 vaccine and 44.32 Euro (median 32.79 Euros) for one with an effectiveness of 60%. Our results indicate that age category, country of residence, income, health state and well-being are important determinants for the WTP. In January 2021, 67.76% of respondents were willing to be vaccinated, 17.57% were unsure, and 14.67% stated they were unwilling to be vaccinated. As expected, being unsure or unwilling to receive a vaccination was associated with a lower WTP. We furthermore find that a higher perceived risk of infection with or health risk of COVID-19, trust in the safety of vaccines and the expected waiting time are associated with a higher WTP for access to a vaccine. In total, 72.6% of respondents were willing to pay for immediate access to a 100% effective vaccine and 69.9% for one that is 60% effective, ranging from the lowest share in the Netherlands (65.5% / 58.4%) to the largest in Portugal (83.1% / 80.9%)