March 2023
Guest editor: Lotte Steuten | Deputy CEO
If equity could go viral
Writing this in the early morning hours after International Women’s Day 2023, equity remains top of mind and I find myself thinking: if only equity could go viral.
The need to #EmbraceEquity has “hit home” harder and for more people as the pandemic magnified every inequality in our societies, including gender, race, health, and socio-economic. The continuing impact of COVID-19 sees health systems in the UK and elsewhere struggling to clear backlogs of treatments, creating pressures on social care and workforce shortages, which contribute to health and other inequalities persisting, if not worsening.
COVID-19, however, is not the only infectious disease to consider. According to the UK Health Security Agency, about 7% of hospital admissions have a primary infection diagnosis and at least one-third of emergency admissions to hospitals receive an antimicrobial therapy to treat infection. Pneumonia and upper respiratory infections are the most common diagnoses.
Research by OHE shows that, in the English NHS, the health system capacity value generated by vaccination programs increases with excess demand for healthcare services. For some vaccination programs, such as flu, meningococcal type B disease, rotavirus, and pneumococcal disease, the full opportunity costs avoided by keeping patients with a vaccine-preventable disease from needing a hospital bed are twice the direct costs saved by avoiding that hospitalisation.
The full societal value of vaccination, e.g., including productivity costs and equity considerations, is even larger and typically underestimated, which led to the development of an expert-based conceptual framework capturing the broader value elements of vaccines and suggesting methods to quantify value elements not routinely considered in health technology assessment. Further research is needed, though, and I would welcome your submission to our special issue in Vaccine.
Like viruses, however, inequalities can’t be stopped by country borders. The value of broad and equitable access to COVID-19 vaccines globally is large and circular: we conservatively estimated that every dollar spent by advanced economies on vaccinations for less advanced economies would avert 29 dollars of economic losses in those less advanced economies, and another 28 dollars in the advanced economies themselves.
For that to happen, it is critical that local decision-makers across the world understand the broader value of vaccination, not only for COVID-19 but importantly also for other lifecycle vaccination programmes. One step to achieve that, quoting Jacinda Ardern, is to make sure that “every [country] regardless of developmental status, regardless of wealth, has access to the same tools that everyone needs to look after their citizens”.
To contribute to this greater understanding, we have launched The Economics of Vaccines and Immunisation in Africa (EVIA) Programme. EVIA is a free–to–access, fully virtual, multi–language e–learning programme to build the capacity among sub–Saharan African policymakers and immunisation managers to 1) assess the costs, consequences, and value for money of vaccines through economic evaluation; 2) make evidence–based decisions around national immunisation programmes.
The course draws on local examples and highlights current policy issues in the region and is also applicable to policymakers and programme managers from other countries who implement the Expanded Programme on Immunisation. So far, the course has attracted delegates from 42 countries, and we look forward to welcoming many more. It takes all of us to make equity go viral.
NEW FROM OHE
In this paper, an OHE expert investigates which decision theory best explains life satisfaction by reviewing data reported in an annual household panel.
The two most prominent decision theories in economics: expected utility theory (EUT), and prospect theory (PT) are considered across three outcomes consistently found to improve life satisfaction: income, health, and employment.
The results suggest that life satisfaction is best described by expected utility theory, but contains some aspects of prospect theory.
Marking International Women's Day 2023
In 2021 we noted, that of all plenary speakers at ISPOR conferences the percentage of women increased from 26% in 2016 to 42% in 2019. That positive trend has continued and reached 49% in 2021.
Whilst this is only one measure for charting progress it is also encouraging to note that there is a majority of women candidates in the ongoing elections for the ISPOR 2023-2026 Board of Directors positions which close for voting on 1 April, 2023.
A raft of potentially curative therapies are now reaching the market. 12 FDA-approved already and another seven expected in 2023.
The high price tags for these therapies is creating challenges for payers - but a range of novel payment approaches are being proposed. Some have already been trialled for certain scenarios, such as hepatitis C and antibiotics.
In this article OHE experts take PharmaVoice editor Meagan Parrish through some of the options.
NEWS HIGHLIGHTS
At the start of 2022, the COVID-19 vaccination rate was less than 5% on average in the 16 participating countries. According to the WHO, that rate is now closing in on 30% – the continent’s average – among the 14 countries whose data was available in January.
To achieve those rising numbers, national health workers trained by WHO experts have been administering vaccines in urban hubs, remote villages, refugee and displacement camps, workplaces, public spaces and elsewhere.
Africa currently produces only one percent of its routine vaccines, causing over-reliance on imports for its vaccine needs. Infrastructure and technology to locally produce vaccines is lacking.
One solution, according to Deborah King, vaccines research lead at Wellcome, is advance purchase agreements, where governments agree to buy a specific number of jabs ahead of them being produced. This could get necessary funding to produce vaccines on the continent, while also ensuring profitability for the manufacturers.
U.S. President Joe Biden will seek to raise the Medicare tax on high earners and push for more drug price negotiations to help keep the federal health insurance program solvent through at least 2050 as part of his budget proposal this week.
"Let’s ask the wealthiest to pay just a little bit more of their fair share, to strengthen Medicare for everyone over the long term," Biden wrote separately in a New York Times guest essay that was published on Tuesday.
CURRENT OPPORTUNITIES
Deadline | 30 April 2023
We actively support the next generation of health economists in a range of ways. If you are looking to undertake an MSc in Health Economics, apply for our Fellowship Programme with City, University of London by 30 April 2023.
Deadline | 27 April 2023
We are delighted to collaborate with LSE Department of Health Policy on a new PhD studentship.
Apply if you are interested in conducting research at the intersection of life sciences and health economics by 27 April 2023.
Deadline | 21 March 2023
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