because the vaccine only confers immunity for one season, i.e. it needs to be administered every year (high delivery costs) and has high morbidity associated with the disease (high health care costs). However, despite the high direct costs, the hypothetical influenza vaccine can lead to large workforce productivity gains, $3,345 million, due to the large number of flu cases prevented each year.

Ideally, a vaccine candidate would reflect the least amount of net direct costs per year, which are calculated as delivery costs–health care costs. Correspondingly, in an ideal situation, the delivery costs for the vaccine would be low because the long length of conferred immunity would preclude many from receiving the vaccine each year while the health care costs associated with the targeted disease would decrease as the vaccine would reduce mortality and morbidity initially caused by the disease. Such a vaccine would also have a low cost effectiveness rate with larger gains in health (i.e., QALYs) and lower costs.

Lastly, because health and economic measures of a vaccine are quantifiable and are generally the important elements in decision making, users interested in these aspects of a vaccine will rank health and economic attributes highly, thus weighing health and economic measures highly within their SMART Score output. Hence, a detailed understanding of the quantifiable attributes will inform the user in selecting, ranking, and weighing attributes.



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