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TABLE 9.7 Sensitivity Analysis: Effect of an Alternative Development Scenario on Potential Health Benefits

 

Predicted Probability of Successful Development (Central Analysis)

100% Probability of Successful Development

Vaccine

Rank

Value (IME Units)

Rank

Value (IME Units)

S. pneumoniae

1

1,363,943

1

1,704,929

Rotavirus (HPBRV)

2

521,852

4

579,836

Malaria (monovalent)

3

475,205

2

950,410

Rotavirus (LPBRV)

4

450,795

5

563,494

Rotavirus (RMRV)

4

450,795

5

563,494

S. typhi (Ty21a)

6

431,471

7

479,412

Malaria (multivalent)

7

426,640

3

853,280

Shigella

8

222,096

9

317,280

Hepatitis B

9

213,192

13

215,346

H. influenzae b

10

210,943

11

234,381

S. typhi (aa-strain)

11

194,745

8

317,491

Streptococcus group A

12

180,513

12

225,641

E. coli (attenuated live)

13

145,260

14

207,514

E. coli (purified antigens)

14

126,454

10

252,908

V. cholera (attenuated live)

15

94,986

16

126,647

M. leprae

16

88,481

15

176,963

V. cholera (inactivated)

17

65,548

17

100,843

RSV (attenuated live virus)

18

59,559

18

74,449

RSV (glycoprotein)

19

52,412

19

65,515

Parainfluenza viruses

20

43,692

20

54,615

Rabies (Vero cell derived)

21

41,910

21

46,567

Rabies (glycoprotein)

22

37,983

22

44,686

Hepatitis A (attenuated live virus)

23

15,112

25

15,907

Hepatitis A (polypeptide)

24

14,392

26

15,149

N. meningitidis

25

13,754

23

27,509

Yellow fever virus

26

11,127

28

11,713

Dengue virus

27

9,558

27

12,744

Rabies (live vector virus)

28

8,260

24

16,520

Japanese encephalitis virus

29

3,232

29

6,465

CONCLUSIONS

Final decisions on the number of vaccines and the particular vaccines selected for accelerated development must incorporate various nonquantifiable factors, as well as information provided by the rankings that were derived with the proposed system for calculating benefits and expenditures. The additional factors include:

  • goals of the responsible agency and its schedule for achieving them

  • ethical questions on the distribution of benefits among socioeconomic or age groups, countries, or regions

  • most appropriate points in the development process at which the agency can exert influence and the opportunity and need for such influence

  • extent of private sector activities



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