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1. Summary
Pages 1-18

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From page 1...
... In this analysis, benefit values represent potential benefits, and potential expenditures on vaccines are the only cost component evaluated (cost savings from treatment averted are not assessed)
From page 2...
... This is expressed in the sensitivity analyses reported in the study. All processes in which diseases are ranked by importance involve value judgments on disease conditions; incorporation of value judgments may be explicit, implicit, or unrecognized.
From page 3...
... · arguments that can be made for treating certain vaccine development projects as unique because of their potential for facilitating immunization programs in general (e.g., by eliminating constraints on delivery, such as poor stability) or by improving public confidence (e.g., by reducing adverse reactions)
From page 4...
... It is recognized that scientific opinion differs on some of the judgments and that uncertainty surrounds other factors, for example, probable vaccine efficacy and disease incidence. The final format allows users of the system to perform sensitivity analyses in which an estimate or prediction in a specific area, such as the probability of success, can be varied systematically across its plausible range to examine its impact on the final result.
From page 6...
... Probably plasmid mediated outer Infants at birth or earliest membrane protein invasion deters possible age; elderly for a';nant (there are a small number epidemic strafe of promising options needing investigation to determine best approach) Streptococcus A Synthetic M protein segment Children, < 3-4 yrs (excluding portions cro~ reacting with h''mP" tissue)
From page 7...
... Infant Mortality Equivalence Values An important feature of the system is that it allows the user to change the perspective on disutility of disease consequences to any level desired and to observe the effect of this change on the rankings of candidates. The undesirability of conditions for morbidity category/ age group combinations are expressed as infant mortality equivalence (IME)
From page 8...
... 0 o hat It)
From page 9...
... Total Disease Burden Values The system that has been developed provides a means for comparing diseases, as well as a method for comparing vaccines. The total disease burden value {TDBV)
From page 10...
... In this report, however, utilization is not used to differentiate among vaccine candidates. Estimation of Time to Licensure, Time to Vaccine Adoption, and Delay of Vaccination Benefits: Discounting Various vaccines require various amounts of time for development to licensure, and after licensure before wide incorporation into general
From page 11...
... (When it is believed that vaccines may have different utilization rates within their respective target populations, predicted rates can be used as an adjustment in this calculation process and the values derived would represent expected, rather than potential, health benefits.) Cost Calculations A comprehensive assessment of the expected net costs associated with the use of vaccine candidates would require the calculation of the cost of vaccine development, the cost of the immunization program including vaccine administration, the cost savings from treatment averted, and the cost of adverse reactions.
From page 12...
... Net costs may in fact be negative; that is, a vaccine can be cost saving. DISEASE BURDEN ESTIMATES (adjust for undesirability of disease conditions using infant mortality equivalence values)
From page 13...
... ANNUALIZED PRESENT VALUE OF POTENTIAL EXPENDITURES ON VACCINES FIGURE 1.2 Calculations of expenditures on vaccines. INTERPRETATION OF RESULTS DEFINITION OF TARGET POPULATION ESTIMATED ANNUAL NUMBER OF NEW POTENTIAL VACCINEES (calculate costs based on cost per dose and number of doses per course)
From page 14...
... , and shigella consistently rank among the top 10 positions in priority lists based on potential health benefits under a wide range of assumptions and resource availabilities (Table 1.5 and Chapter 9~. As willingness to pay to obtain health benefits drops to $1,000 or below per IME prevented, the rankings change more significantly.
From page 15...
... (Rotavirus) Hemophilus influenzas type b Vibrio cholera Respiratory syncytial virus Parainfluenza virus Neisseria meningitidis l Rabies virus Dengue virus Yellow fever virus Hepatitis A virus Japanese encephalitis virus .
From page 16...
... Hepatitis A (polypeptide) _ meningitidis Yellow fever virus Dengue virus Rabies (live vector virus)
From page 17...
... 17 5: a, lo: .,.
From page 18...
... After the committee achieved consensus on vaccine development predictions (late summer 1985) preliminary unpublished results from ~ ~ ~ ~ These results, if some vaccine certain ongoing studies came to their attention.


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