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Systematic review of economic evaluations of vaccination programs in mainland China: Are they sufficient to inform decision making?
- Source :
- Vaccine. 33:6164-6172
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- The purpose of the study was to systematically review economic evaluations of vaccine programs conducted in mainland China. We searched for economic evaluations of vaccination in China published prior to August 3, 2015 in eight English-language and three Chinese-language databases. Each article was appraised against the 19-item Consensus on Health Economic Criteria list (CHEC-list). We found 23 papers evaluating vaccines against hepatitis B (8 articles), Streptococcus pneumoniae (5 articles), human papillomavirus (3 articles), Japanese encephalitis (2 articles), rotavirus (2 articles), hepatitis A (1 article), Enterovirus 71 (1 article) and influenza (1 article). Studies conformed to a mean of 12 (range: 6-18) items in the CHEC-list criteria. Five of six Chinese-language articles conformed to fewer than half of the 19 criteria items. The main criteria that studies failed to conform to included: inappropriate measurement (20 articles) and valuation (18 articles) of treatment and/or vaccination costs, no discussion about distributional implications (18 articles), missing major health outcomes (14 articles), no discussion about generalizability to other contexts (14 articles), and inadequate sensitivity analysis (13 articles). In addition, ten studies did not include major cost components of vaccination programs, and nine did not report outcomes in terms of life years even in cases where QALYs or DALYs were calculated. Only 13 studies adopted a societal perspective for analysis. All studies concluded that the appraised vaccination programs were cost-effective except for one evaluation of universal 7-valent pneumococcal conjugate vaccine (PCV-7) in children. However, three of the five studies on PCV-7 showed poor overall quality, and the number of studies on vaccines other than hepatitis B vaccine and PCV-7 was limited. In conclusion, major methodological flaws and reporting problems exist in current economic evaluations of vaccination programs in China. Local guidelines for good practice and reporting, institutional mechanisms and education may help to improve the overall quality of these evaluations.
- Subjects :
- Mainland China
China
medicine.medical_specialty
Hepatitis B vaccine
Cost-Benefit Analysis
Decision Making
Pneumococcal Infections
Pneumococcal conjugate vaccine
Humans
Medicine
Generalizability theory
Vaccines
General Veterinary
General Immunology and Microbiology
Cost–benefit analysis
Immunization Programs
business.industry
Public Health, Environmental and Occupational Health
Hepatitis A
medicine.disease
Vaccination
Infectious Diseases
Virus Diseases
Family medicine
Economic evaluation
Molecular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 0264410X
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Vaccine
- Accession number :
- edsair.doi.dedup.....0d50eccc99674c443c7554079abba818