Essays in Applied Vaccine Economics

  • Author / Creator
    Waye, Arianna E.
  • 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.

  • Subjects / Keywords
  • Graduation date
    Fall 2013
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
  • Supervisor / co-supervisor and their department(s)
  • Examining committee members and their departments
    • Kaul, Padma (Medicine)
    • Tan, Ben (Medicine)
    • Ohinmaa, Arto (School of Public Health)
    • Chuck, Andersen (School of Public Health)
    • Forget, Evelyn (Medicine)