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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.

References

Dalkey, N.C. 1969. The Delphi Methods An Experimental Study of Group Opinion. Research Memorandum RM-58888-PR. Santa Monica, Calif.: The Rand Corporation.

Keeney, R.L., and H.Raiffa. 1976. Decisions with Multiple Objectives: Preferences and Value Tradeoffs. New York: John Wiley and Sons.

National Academy of Sciences. 1975. Environmental Impact of Stratospheric Flight. Appendix K. Washington, D.C.: National Academy Press.

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.

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.



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