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New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986)
Board on Population Health and Public Health Practice (BPH)

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. "3. Overview of the Analytic Approach." New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries. Washington, DC: The National Academies Press, 1986.

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries

TABLE 3.1 Sample Array of Hypothetical Benefits and Expenditures for Various Vaccines

Vaccine

Annualized Present Value of Potential Health Benefits

Annualized Present Value of Potential Expenditures on Vaccines ($ millions)

A

250

10

B

200

20

C

200

40

D

100

80

E

150

100

F

100

200

G

125

300

H

105

400

I

150

500

J

80

1,000

NOTE: Health benefits may be expressed in any unit as long as it is used consistently for all diseases or vaccines.

After all assumptions and estimates have been made and all calculations performed, the analysis yields the annualized potential health benefits of and the annualized potential expenditures on vaccines for each candidate. These could be arrayed in a table like that shown in Table 3.1. The entries in the table illustrate the interpretation of conceivable results and do not represent actual results.

Table 3.1 summarizes results for 10 vaccine candidates, A through J. Each project is associated with a potential expenditure and a potential benefit, both adjusted to their present values to make results with different time horizons comparable to one another, and converted to annualized equivalents. The figures take into account many (but not all) uncertainties that apply to the development, use, and consequences of each vaccine. However, some factors (e.g., utilization) are assumed not to differentiate between vaccine projects, and some costs or possible savings (e.g., treatment cost savings), which may differentiate between projects, are not included in the calculations. Hence, the values are not real or absolute. Within a category they should only be regarded as relative. That is, differences between benefits of vaccine candidates or differences between costs are meaningful, but comparisons of benefits and costs for a particular vaccine are not.

Built into the interpretation of these results is an assumption that society is risk-neutral with respect to alternative vaccine investments. This means, for example, that the benefits from a vaccine investment that has a 50 percent chance of ultimately saving 2,000 lives per year are valued the same as the benefits from an alternative vaccine investment that has a 25 percent chance of ultimately saving

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Front Matter (R1-R16)
1. Summary (1-18)
2. Priority Setting for Health-Related Investments: A Review of Methods (19-29)
3. Overview of the Analytic Approach (30-43)
4. Comparison of Disease Burdens (44-62)
5. Predictions of Vaccine Development (63-75)
6. Assessing the Likely Utilization of New Vaccines (76-81)
7. Calculation and Comparison of the Health Benefits and Differential Costs Associated with Candidate Vaccines (82-105)
8. Additional Issues in the Selection of Priorities for Accelerated Vaccine Development (106-120)
9. Findings, Conclusions, and Recommendations (121-142)
Appendix A: Selection of Vaccine Candidates for Accelerated Development (143-148)
Appendix B: The Burden of Disease Resulting from Acute Respiratory Illness (149-158)
Appendix C: The Burden of Disease Resulting from Diarrhea (159-169)
Appendix D-1: The Prospects for Immunizing Against Dengue Virus (170-177)
Appendix D-2: The Prospects for Immunizing Against Escherichia coli (178-185)
Appendix D-3: The Prospects for Immunizing Against Hemophilus influenzae Type b (186-196)
Appendix D-4: The Prospects for Immunizing Against Hepatitis A Virus (197-207)
Appendix D-5: The Prospects for Immunizing Against Hepatitis B Virus (208-222)
Appendix D-6: The Prospects for Immunizing Against Japanese Encephalitis Virus (223-240)
Appendix D-7: The Prospects for Immunizing Against Mycobacterium leprae (241-250)
Appendix D-8: The Prospects for Immunizing Against Neisseria meningitidis (251-266)
Appendix D-9: The Prospects for Immunizing Against Parainfluenza Viruses (267-274)
Appendix D-10: The Prospects for Immunizing Against Plasmodium spp. (275-286)
Appendix D-11: The Prospects for Immunizing Against Rabies Virus (287-298)
Appendix D-12: The Prospects for Immunizing Against Respiratory Syncytial Virus (299-307)
Appendix D-13: The Prospects for Immunizing Against Rotavirus (308-318)
Appendix D-14: The Prospects for Immunizing Against Salmonella typhi (319-328)
Appendix D-15: The Prospects for Immunizing Against Shigella spp. (329-337)
Appendix D-16: The Prospects for Immunizing Against Streptococcus Group A (338-356)
Appendix D-17: The Prospects for Immunizing Against Streptococcus pneumoniae (357-375)
Appendix D-18: The Prospects for Immunizing Against Vibrio cholerae (376-389)
Appendix D-19: The Prospects for Immunizing Against Yellow Fever (390-402)
Appendix E: Questionnaire for Assessing Morbidity-Mortality Trade-Offs (403-411)
Appendix F: Technical Notes (412-412)
Appendix G: Biographical Notes on Committee Members (413-417)
Appendix H: Additional Sources of Advice to the Committee (418-419)
Appendix I: Contents of Supplement to Volume II (420-420)
Appendix J: Preface to Volume I (421-422)
Appendix K: Contents to Volume I (423-423)
Index (424-432)