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Little is known about the role of (economic) information or evidence in the different stages of the decision-making process on vaccine introduction. By conducting a document analysis on the public decision-making process of introducing human Papilloma virus (HPV) vaccine into the national vaccination program (NVP) in the Netherlands, we aim to gain insight into which information plays a role during the introduction of a vaccination programme. A document analysis was performed on the public decision-making process regarding the introduction of HPV vaccine into the NVP in the Netherlands. Information used or asked for by various stakeholders during different stages of the policymaking process was identified. In total, 42 documents were found, analyzed and synthesized, for the period between August 2006 and September 2009. Documents were analyzed using directed content analysis based on eight broad categories of criteria used in decision-making frameworks for introducing a vaccine. Our analysis demonstrates that a wide variety of stakeholders is involved in the process. Financial or economic issues were stipulated in 64.3% of the documents and information on vaccine characteristics were discussed in 59.5%. Economic information from economic evaluations was discussed most (47.6%). Based on our analysis, it can be concluded that economic information, in particular information from economic evaluations, played an important role in the decision-making process regarding the introduction of HPV-vaccination., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objectives: The aim of this study was to investigate how the societal perspective is conceptualized in economic evaluations and to assess how intersectoral costs and benefits (ICBs), that is, the costs and benefits pertaining to sectors outside the healthcare sector, impact their results., Methods: Based on a search in July 2015 using PubMed, Embase, CINAHL, and PsychINFO, a systematic literature review was performed for economic evaluations which were conducted from a societal perspective. Conceptualizations were assessed in NVivo version 11 using conventional and directed content analysis. Trial-based evaluations in the fields of musculoskeletal and mental disorders were analyzed further, focusing on the way ICBs impact the results of economic evaluations., Results: A total of 107 studies were assessed, of which 74 (69.1 percent) provided conceptualizations of the societal perspective. These varied in types of costs included and in descriptions of cost bearers. Labor productivity costs were included in seventy-two studies (67.3 percent), while only thirty-eight studies (35.5 percent) included other ICBs, most of which entailed informal care and/or social care costs. ICBs within the educational and criminal justice sectors were each included five times. Most of the trial-based evaluations analyzed further (n = 21 of 28) reported productivity costs. In nine, these took up more than 50 percent of total costs. In several studies, criminal justice and informal care costs were also important., Conclusions: There is great variety in the way the societal perspective is conceptualized and interpreted within economic evaluations. Use of the term "societal perspective" is often related to including merely productivity costs, while other ICBs could be relevant as well.