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Permanent link (DOI): https://doi.org/10.7939/R3G97Z

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Essays in Applied Vaccine Economics Open Access

Descriptions

Other title
Subject/Keyword
Effectiveness
Cost
Economics
Varicella
Research and Development
Vaccine
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Waye, Arianna E.
Supervisor and department
Jacobs, Philip (Medicine)
Examining committee member and department
Tan, Ben (Medicine)
Chuck, Andersen (School of Public Health)
Kaul, Padma (Medicine)
Ohinmaa, Arto (School of Public Health)
Forget, Evelyn (Medicine)
Department
Department of Medicine
Specialization

Date accepted
2013-09-25T15:03:38Z
Graduation date
2013-11
Degree
Doctor of Philosophy
Degree level
Doctoral
Abstract
Objectives: This thesis consists of 3 partial vaccine economic evaluations. The objectives were to: 1) estimate the effectiveness of Canada’s universal varicella childhood immunization strategy on varicella-related hospitalizations, 2) measure the economic impact of Alberta’s universal childhood pneumococcal immunization program (Prevnar 7), and 3) generate a general model estimating the cost of vaccine research, development, and deployment (RDD). Methods: For the first objective, rate ratios were calculated based on pre- and post- cases hospitalization across 10 provinces, and 6 age categories. For the second objective, an ex post cost analysis was conducted, comparing the costs associated with pneumococcal both before and after the introduction of universal Prevnar 7 immunization. The third objective was met by modifying cost models from the drug development literature. Results: For the first objective, there was evidence of significant declines in varicella across all provinces in Canada, across most age categories less than 40, suggesting some evidence of herd immunity effect. For the second objective, the costs averted in Alberta as a result of decreased cases of pneumonia were $9.2 million and $1.8 million if serotype replacement is taken into account. For the third objective, Rotarix was used as a case example to demonstrate the vaccine costing model. It is found that it cost an estimated $2.7 billion to develop Rotarix vaccine, and $3.7 billion after consideration of risk premiums. Conclusions: For objective one, the Canadian immunization strategy has been successful in reducing varicella-related hospitalizations across the country, and across ages. For the second objective, costs have been averted in Alberta as a result of decreased cases of pneumonia due to PCV7. However, the relationship between the vaccine and serotype replacement could erode some of these benefits. For the third objective, a general model has been created that can estimate the cost of vaccine RDD. This model can be used to estimate cost of RDD for any vaccine in which the cost of clinical testing is known.
Language
English
DOI
doi:10.7939/R3G97Z
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
Waye A, Jacobs P, Tan B. The Impact of the Universal Infant Varicella Immunization Strategy on Canadian Varicella-Related Hospitalization Rates. Vaccine 2013;31:4744-8.Waye, A., Jacobs, P., Schryvers T. Expert Reviews. 2013

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