Vaccination gets you wealthier.

Size: px

Start display at page:

Download "Vaccination gets you wealthier."

Russell Bradley
5 years ago
Views:

1 Vaccination gets you wealthier. A: What makes you healthier? B: What makes you wealthier? A: Google 58,000,000 hits B: Google 500,000,000 hits Wealth to health ratio is 10:1 Prof. David M Salisbury CB Director of Immunisation, Department of Health, London.

The vaccine business is booming, spurred by worldwide efforts to contain the global influenza pandemic and to halt the spread of AIDS and other lethal infectious diseases.

2 The vaccine business is booming, spurred by worldwide efforts to contain the global influenza pandemic and to halt the spread of AIDS and other lethal infectious diseases. National health agencies ordered millions of H1N1 swine-flu vaccine doses in 2009, prompting manufacturers to ramp up production as well as investment in research and development (R&D). Since 2000, the global vaccine market has almost tripled to reach as estimated $20 billion. Feb 2, 2010 By: Jill Wechsler Pharmaceutical Technology Volume 34, Issue 2, pp

4 Do vaccines improve the national wealth as well as the national health? Department of Health internal analysis 2011 If the current 10 routine vaccinations were withheld from a year s worth of children, over their lifetimes they would lose approximately 320,000 quality-adjusted life years (QALYs). The 320,000 QALY figure suggests that if the current 10 routine vaccinations were withheld, each child would lose approximately 0.52 years of life expectancy. The models follow a cohort of 100,000 births over 100 years. The model incorporates NHS and non-nhs costs. NHS costs include costs such as vaccine price, hospital bed-day costs, nurse time costs, etc. Non-NHS costs include the costs of parent time when taking a child to be vaccinated, the costs of parents looking after sick children, the income loss of a patient with long-term sequelae, etc. The net benefit of the intervention per 100,000 is calculated by finding the monetised QALY loss difference and subtracting the cost difference. Initial results are given per 100,000 births, scaled up by 6.2 to represent the costs and benefits per English birth cohort.

5 TOTAL NET BENEFIT of all 10 vaccination programmes with herd effect, NHS and Non-NHS costs:

7 Counting The Costs of Meningitis A S E V E R E C A S E O F M E N I N G O C O C C A L D I S E A S E

9 Peter was 18 months old when he was rushed to Emergency with suspected meningococcal disease. He was stabilised and transferred by a specialist team to the nearest hospital with a Paediatric Intensive Care Unit (PICU) COST - 2,828 He spent a total of 31 days in PICU with severe septic shock, acute respiratory distress syndrome and renal failure COST - 72,136 Acute Costs

10 Acute Costs Peter developed purpura fulminans and after PICU was transferred to a paediatric ward: Total 155 days Severe gangrene in three limbs resulted in a bilateral amputation of the legs above the knee and amputation of the left arm below the elbow He returned to theatre for dressing 148,566 changes and further removal of dead skin and bone twice in the four days following amputation Multiple skin grafting operations took place to repair damaged areas of skin in the subsequent months COST - 76,431 Total Acute Costs

After Effects Peter returned home after 6 months with bilateral above knee amputations and amputation of the left arm below the elbow He had extensive skin damage and scarring A couple of

11 After Effects Peter returned home after 6 months with bilateral above knee amputations and amputation of the left arm below the elbow He had extensive skin damage and scarring A couple of years after recovery from the illness it became apparent that he had behavioural problems. At school it became clear that he had mild learning difficulties affecting concentration and memory

every 3 months, but gradually became yearly as Peter became an adult COST - 325 per appointment Combined clinics

12 Outpatient Appointments Disablement services centre: Consultant in Rehabilitation medicine Prosthetist Physiotherapist Occupational Therapist Counsellor Appointments at the disablement services centre were initially every 3 months, but gradually became yearly as Peter became an adult COST per appointment Combined clinics with a plastic and orthopaedic surgeon took place on a six monthly basis until Peter stopped growing COST per appointment

13 Outpatient Appointments A hospital physiotherapist worked with Peter outside of the routine appointments at the disablement services centre when new prosthetic legs were provided COST - 44 per hour Outpatient Appointments A hospital OT also worked with Peter outside of the routine Lifelong costs appointments to provide specialist upper limb tools to aid him in a particular task 54,276 COST - 44 per hour In addition, Peter had appointments with the hospital paediatrician every 3 months until age 3 when he was referred to a community paediatrician COST - 34 per appointment

14 Life Long Medical Costs Acute Care Hospital Costs - 148,566 Outpatient Appointment Costs - 54,276 Prosthetic Provision Costs- 694,646 Medical Costs Specialist Equipment Costs - 26,654 Lifelong costs Additional Surgery Costs - 20, ,156 Community Health Costs 9,466 Behavioural Management Costs - 28,350

29 Fig 3 Incremental cost effectiveness ratios for equally priced quadrivalent and bivalent vaccines under the different scenarios described in table 1. Jit M et al. BMJ 2011;343:bmj.d by British Medical Journal Publishing Group

31 Vaccination gets you wealthier. The vaccine segment of the pharmaceutical industry is predicted to continue to grow and will expand beyond infectious diseases into cancer, chronic disease, addiction, hypertension. The vaccine industry needs to be profitable for investments to be made into new vaccine development. Vaccines must provide value for money to whoever is the purchaser individuals, insurers or national governments. Assessing value requires explicit criteria to be developed, yardsticks of preparedness to pay to be established, and vaccines treated in exactly the same way as other pharmaceutical interventions as long as common criteria and a common yardstick is used. When vaccines are cost-effective, their use should be strongly supported. Supporting non-cost effective use of vaccines will ultimately be detrimental.

NATIONAL REHABILITATION HOSPITAL (NRH) THE SPINAL CORD SYSTEM OF CARE (SCSC) PROGRAMME INPATIENT SCOPE OF SERVICE

NATIONAL REHABILITATION HOSPITAL (NRH) THE SPINAL CORD SYSTEM OF CARE (SCSC) PROGRAMME INPATIENT SCOPE OF SERVICE NATIONAL REHABILITATION HOSPITAL SCOPE OF SERVICE FOR THE SPINAL CORD SYSTEM OF CARE PROGRAMME