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bility of successful development and the time at which benefits would occur.

The vaccination program costs used in calculating net costs are those of a mixed public-private program, because this type of delivery system appears to be the most likely to develop.*

All expected costs are adjusted to take into account the anticipated utilization of vaccines. The annualized present value of expected net costs also is adjusted to reflect the probability of each vaccine’s successful development and the time that costs and benefits would occur.

These calculations of costs can be used to compare vaccine candidates from a variety of viewpoints, as discussed in Chapter 9. Sensitivity analyses described in that chapter also show the effects on the rankings of assumptions other than those used in the central analysis.

References

Bureau of the Census. 1984. Projections of the Population of the United States by Age, Sex, and Race: 1983 to 2080. Current Population Reports, Series P-25, No. 952. U.S. Department of Commerce, Washington, D.C.

Hinman, A.R., and J.P.Koplan. 1984. Pertussis and pertussis vaccine: Re-analysis of benefits, risks, and costs. JAMA 251:3109–3113.

Lederle Laboratories. 1984. Physician’s advisory.

Office of Technology Assessment. 1981. Cost Effectiveness of Influenza Vaccination. United States Congress, Washington, D.C.

United States Public Health Service. 1980. Promoting health/ preventing disease: objectives for the nation. Washington, D.C.: U.S. Public Health Service.

Weinstein, M.C., and W.B.Stason. 1977. Foundations of cost-effectiveness analysis for health and medical practices. N. Engl. J. Med. 296(13):716–721.

*

Any delivery of adult vaccines through public programs is considered to be too limited to affect the price per dose or the average cost of delivery. Thus, the assumption of a mixed public-private program has the effect of lowering the costs of pediatric vaccination programs relative to adult programs.



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