Room: Phillips 231
Time: Wed 08:30 AM-10:00 AM

The Economics of Vaccine Decisions, Perspectives, and Methods

Chair: Frank Sloan (Duke University)

Session Description

Vaccines are widely regarded as among the best successes in medicine and public health. They have reduced the risk of many serious diseases and effectively eradicated several illnesses, such as polio, from most regions of the globe. Since the development of a vaccine for smallpox over 200 years ago and in the 1950s for polio, vaccines have been a part of routine care for children in many parts of the world. Most modern vaccines are inexpensive, highly effective, and very safe.
Most vaccines have both a direct private benefit, from individual protection, and a positive externality, reduced disease risk to others, or “herd immunity.” This presents an intriguing research topic for health economists as well as a potential public health dilemma for public health officials and physicians. The high efficacy and widespread use of vaccines in the population may reduce the individual marginal benefit of vaccines, a classic free-rider problem. These factors may differentially affect optimal allocations from individual vs. societal perspectives.
This session will focus on the economics of vaccine decisions from different analytic perspectives and using three different major evaluation methods:

Brown et al. developed a conjoint analysis survey to quantify parent preferences for pediatric vaccines. Their data provides estimates of willingness to pay and predicted uptake for current and potential future recommended vaccines under a variety of policy scenarios.
Ibuka et al. explores free-riding behavior and the problem of externalities in individuals’ vaccine decisions using a unique, computerized experimental economics study of 269 undergraduates at Rutgers University. They find a significant free-rider effect and also identify the importance of individuals’ own health experiences with the flu.
Messonnier et al. explores subtle externalities and spillover effects using a CEA model and societal perspectives. Specifically, they show how CEA results for a pneumococcal vaccine (PPV23) are impacted by potential pandemic flu, a condition only indirectly related to pneumococcal. This research will dovetail nicely with that by Brown & Ibuka, since individuals may not internalize the benefits in the societal CEA.

This session directly addresses the “health, healthcare, and behavior” features of the ASHE 2010 conference theme. The subject of vaccines is both a public “health” and a “healthcare” systems topic, with vaccines being an extremely common healthcare service that affects both individual and societal health. The research by Brown and Ibuka addresses “behavior” by focusing on the determinants of individual decisions, while Messonnier’s research has implications for “health” and “healthcare” from a social perspective.
The roster of session participants spans a diversity of academic, policy, and nonprofit institutions. Discussants have been carefully selected and assigned based on their past experience with vaccine research, conjoint analysis, methods, and industry perspectives.
Session attendees will learn how different perspectives in economic analysis may lead to divergent findings, and how a variety of methods can be applied to analyze economic aspects of vaccines and vaccination decisions. Discussants will be asked to compare and contrast methods and papers at the end of the session.

Key Terms None Listed

Session Organizer: Derek S. Brown (Research Triangle Institute (RTI International))

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Presentations

1. A Conjoint Analysis of Parent Preferences and Willingness to Pay for Pediatric Vaccines

   Presenter: Derek Brown (RTI International)

   Discussant: Teresa Kauf (University of Florida)

2. Free-Riding Behavior in Vaccination Decisions

   Presenter: Yoko Ibuka (Yale University)

   Discussant: David Ridley (Duke University)

3. Cost-Effectiveness of using 23-valent Pneumococcal Polysaccharide Vaccine to Prevent Pneumococcal Pneumonia in Target Population Groups during an Influenza Pandemic in the United States

   Presenter: Mark Messonnier (Centers for Disease Control and Prevention)

   Discussant: Frank Sloan (Duke University)