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Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework

Author

Listed:
  • Natalie Carvalho

    (University of Melbourne)

  • Mark Jit

    (London School of Hygiene and Tropical Medicine
    Public Health England)

  • Sarah Cox

    (Initiative for Vaccine Research, World Health Organization, Program in Applied Vaccine Experiences Scholar)

  • Joanne Yoong

    (University of Southern California
    National University of Singapore and National University Hospital System)

  • Raymond C. W. Hutubessy

    (Initiative for Vaccine Research, World Health Organization)

Abstract

Background In low- and middle-income countries, budget impact is an important criterion for funding new interventions, particularly for large public health investments such as new vaccines. However, budget impact analyses remain less frequently conducted and less well researched than cost-effectiveness analyses. Objective The objective of this study was to fill the gap in research on budget impact analyses by assessing (1) the quality of stand-alone budget impact analyses, and (2) the feasibility of extending cost-effectiveness analyses to capture budget impact. Methods We developed a budget impact analysis checklist and scoring system for budget impact analyses, which we then adapted for cost-effectiveness analyses, based on current International Society for Pharmacoeconomics and Outcomes Research Task Force recommendations. We applied both budget impact analysis and cost-effectiveness analysis checklists and scoring systems to examine the extent to which existing economic evaluations provide sufficient evidence about budget impact to enable decision making. We used rotavirus vaccination as an illustrative case in which low- and middle-income countries uptake has been limited despite demonstrated cost effectiveness. A systematic literature review was conducted to identify economic evaluations of rotavirus vaccine in low- and middle-income countries published between January 2000 and February 2017. We critically appraised the quality of budget impact analyses, and assessed the extension of cost-effectiveness analyses to provide useful budget impact information. Results Six budget impact analyses and 60 cost-effectiveness analyses were identified. Budget impact analyses adhered to most International Society for Pharmacoeconomics and Outcomes Research recommendations, with key exceptions being provision of undiscounted financial streams for each budget period and model validation. Most cost-effectiveness analyses could not be extended to provide useful budget impact information; cost-effectiveness analyses also rarely presented undiscounted annual costs, or estimated financial streams during the first years of programme scale-up. Conclusions Cost-effectiveness analyses vastly outnumber budget impact analyses of rotavirus vaccination, despite both being critical for policy decision making. Straightforward changes to the presentation of cost-effectiveness analyses results could facilitate their adaptation into budget impact analyses.

Suggested Citation

  • Natalie Carvalho & Mark Jit & Sarah Cox & Joanne Yoong & Raymond C. W. Hutubessy, 2018. "Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Frame," PharmacoEconomics, Springer, vol. 36(1), pages 79-90, January.
    • Handle: RePEc:spr:pharme:v:36:y:2018:i:1:d:10.1007_s40273-017-0569-2
    DOI: 10.1007/s40273-017-0569-2
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884, Decembrie.
    2. Mark Jit & Raymond Hutubessy, 2016. "Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?," Applied Health Economics and Health Policy, Springer, vol. 14(3), pages 245-252, June.
    3. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 367-372, June.
    4. Katelijne Vooren & Silvy Duranti & Alessandro Curto & Livio Garattini, 2014. "A Critical Systematic Review of Budget Impact Analyses on Drugs in the EU Countries," Applied Health Economics and Health Policy, Springer, vol. 12(1), pages 33-40, February.
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