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(1)

where

r

=

discount rate;

CDev

=

cost of vaccine development;

PDev

=

probability of vaccine development;

CVP

=

annual cost of the vaccination program (which includes the the cost [price] of the vaccine CV for the program and the cost of its administration program, Cp);

TUse

=

time until steady-state vaccine use, that is, the time to licensure plus the time to adoption at the predicted use rate;

CTr

=

annual cost of medical treatment averted;

TLag

=

lag between administration of vaccine and realization of health benefits, that is, the delay of vaccination benefits; and

CSE

=

annual medical costs from side effects.

Because of the decision that for a global analysis the estimation of average treatment cost was impractical and because of the judgment (discussed in Chapters 5 and 9) that side effects were likely to be negligible, the above formulation simplifies. The expenditures on vaccines to achieve the anticipated benefits can be expressed as

(2)

where

rCDev

=

amortized cost of vaccine development; and

Net expected health benefits, expressed as the annualized equivalent of the present value, consist of clinical benefits adjusted for adverse side effects of the vaccine. The annualized equivalent may be expressed as

(3)



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