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the most appropriate for ranking vaccines for accelerated development. Such an approach generates substantial information on both the expected health benefits from a vaccine and the costs of achieving those benefits. Unlike the benefit-cost approach, it does not require that a monetary value be placed on health benefits. Information on how to interpret the results of a cost-effectiveness analysis is presented in Chapter 3.

The final portion of this chapter considers some general issues in implementing any ranking methodology. These include how to elicit and weigh estimates, use of the sequential or “lexicographic” method, problems of interdependence among projects, and the “portfolio” problem.


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Office of Technology Assessment. 1980. The Implications of Cost-Effectiveness Analysis of Medical Technology. U.S. Congress. Washington, D.C.: U.S. Government Printing Office.

Swartzman, D., R.A.Liroff, and K.G.Croke, eds. 1982. Cost-Benefit Analysis and Environmental Regulations: Politics, Ethics and Methods. Washington, D.C.: The Conservation Foundation.

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