Ranking Vaccines A Prioritization Software Tool: Phase II: Prototype of a Decision-Support System (2013) / Chapter Skim
Currently Skimming:
Appendix D: Verification and Analyses of the SMART Vaccines Computational Model
Appendix D: Verification and Analyses of the SMART Vaccines Computational Model
Pages 111-124
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 111... ...
Sensitivity analysis is performed on two vaccine candidates (influenza in the United States and tuberculosis in South Africa) to verify model calculations and display how variability in inputs affects health and economic measures output.
|
From page 112... ...
As such, this appendix describes sensitivity analysis scenarios exclusively for attributes of health and economic considerations. Table D-1 presents the calculated health and economic measures for six vaccine candidates in the United States using data available as accompanying datasets.
|
From page 113... ...
Group B Human Pneumococcal Health Measures Streptococcus Papillomavirus Influenza Infection Rotavirus Tuberculosis Premature deaths 1,302 740 11,233 621 102 231 averted per year Incident cases 16,201 2,340 6,119,401 6,562 237,800 6,580 prevented per year QALYs gained 38,430 11,238 115,665 6,534 2,950 6,017 per year DALYs averted 45,960 12,998 100,145 6,323 3,771 6,871 per year Economic Measures Net direct costs 390 –42 1,801 –8 118 256 (savings) of vaccine use per year (millions)
|
From page 114... ...
of vaccine use per year 6 –14 22 –10 (millions) Workforce productivity gained per year (millions)
|
From page 115... ...
The specific input parameters tested include incidence of the disease, case fatality rate, coverage for a vaccine, vaccine effectiveness, administration costs per dose, health care costs and workforce costs. Each parameter is changed in 25 percent increments from the baseline scenario to observe the resulting trend in attribute under consideration.
|
From page 116... ...
Incident Cases Prevented per Year 25000 15000000 Incidence Case Fatality 12500000 20000 Coverage Effectiveness Dose/Admin Costs 10000000 15000 Health Care Costs Workforce Costs Deaths Cases 7500000 10000 5000000 5000 2500000 0 0 -75% -50% -25% BASE 25% 50% 75% 100% -75% -50% -25% BASE 25% 50% 75% 100% Percentage Change from Base Case Percentage Change from Base Case (c) QALYs Gained per Year (d)
|
From page 117... ...
A higher case fatality rate is associated with more deaths and higher health care costs, but net direct costs (delivery costs-health care costs) are shown to decrease because delivery costs are expected to be minimal.
|
From page 118... ...
per DALY Dose/Admin Costs 55000 55000 Health Care Costs 45000 Workforce Costs 45000 35000 35000 25000 25000 15000 15000 5000 5000 -5000 -5000 -75% -50% -25% BASE 25% 50% 75% 100% -75% -50% -25% BASE 25% 50% 75% 100% Percentage Change from Base Case Percentage Change from Base Case (c) Net Direct Costs of Vaccine Use per Year (d)
|
From page 119... ...
An increase in the case fatality rate will lead to a reduction in net direct costs because a higher case fatality rate will result in more deaths and higher health care costs. Finally, because the net direct costs are calculated by subtracting health care costs from delivery costs, low delivery costs for a vaccine will lead to a decrease in net direct costs.
|
From page 120... ...
Health-related attributes include premature deaths averted per year, incident cases prevented per year, QALYs gained per year, and DALYs averted per year. Specific parameters that were tested for sensitivity are the following: incidence of the disease, case fatality rate, coverage for a vaccine, vaccine effectiveness, administration costs per dose, health care costs and workforce costs.
|
From page 121... ...
Incident Cases Prevented per Year 12000 Incidence 70000 Case Fatality 10000 Coverage 60000 Effectiveness 8000 Dose/admin Cost 50000 Health Care Costs Workforce Costs 40000 Deaths Cases 6000 30000 4000 20000 2000 10000 0 0 -75% -50% -25% BASE 25% 50% 75% 100% -75% -50% -25% BASE 25% 50% 75% 100% Percentage Change from Base Case Percentage Change from Base Case (c) QALYs Gained per Year (d)
|
From page 122... ...
per DALY 1000 Dose/admin Cost -250 500 Health Care Costs W orkforce Costs -500 0 -750 -500 -1000 -1000 -1500 -1250 -2000 -1500 -2500 -3000 -1750 -75% -50% -25% BASE 25% 50% 75% 100% -75% -50% -25% BASE 25% 50% 75% 100% Percentage Change from Base Case Percentage Change from Base Case (c) Net Direct Costs of Vaccine Use per Year (d)
|
From page 123... ...
This is because a higher case fatality rate results not only in more deaths but also in a reduction in health care costs because, unlike the case in the United States, in South Africa the costs associated with death from tuberculosis are less than the health care costs for treatment of living tuberculosis patients. This evaluation exercise revealed interesting insights.
|
From page 124... ...
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.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.