Many cost–benefit analyses presume some background rate of inflation in the economy—for example, 2 percent per year—so that $1 million in costs this year becomes $1.02 million in costs the following year. Adjusting for inflation before discounting is equivalent to simply computing all future economic costs and benefits in today’s dollars at today’s prices and not worrying about what inflation might be in the future. This is the approach taken by the current model. This is done to avoid questions concerning what inflation rate is appropriate—consumer price inflation, monetary inflation, or sectoral inflation confined to health care. For example the inflationary growth in wages, used to measure worker productivity losses and gains, is quite different from inflation in the costs of health care, which itself is a market basket of services and durable goods with different rates of inflation.

Time horizon and uncertainty

This model always operates within a fixed 100-year time horizon. This has been done to simplify the software programming and to reduce the potential for coding errors. SMART Vaccines Beta does not include the ability to set distributions on the input parameters to reflect uncertainties relating to the disease or vaccine data. Therefore, in its current version the multi-attribute output values do not have standard errors. A dynamic sensitivity analysis may be required to detect changes in the priority score with changes in key values. These possibilities, along with others, are discussed in Chapter 3.

The committee’s prototyping and testing efforts are described in Chapter 3, which also provides representative screenshots of SMART Vaccines Beta.



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