Section introduction: Economic evaluation of vaccines and vaccine programs

Economic evaluation is the key approach to modeling the value of vaccines. These methods compile information about cost, clinical benefits, and probabilities of different outcomes in order to draw conclusions about the cost-effectiveness and budget impact of vaccines for particular communities based on what we know about the initial efficacy of immunization programs. These economic models are convenient since they allow us to forecast value of vaccines even with limited data by drawing assumptions based on the past successes and failures of previous immunization programs. This chapter guides readers through the theoretical foundations as they apply to medical cost-effectiveness analysis, which applied examples in vaccine economics. The chapter leverages simple decision models to base its teachings on. Subjects such as the derivation of health utilities, including quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs) are covered here, as well as cost-effectiveness thresholds and their link to opportunity costs when communities overspend on vaccines for limited populations. More advanced methods in economic evaluation, including Markov modeling and sensitivity analysis are covered further in the next chapter, 4.0.