Potential conflicts of interest in vaccine economics research: a commentary with a case study of pneumococcal conjugate vaccination.

The main potential areas of bias in economic evaluation (EE) in health care can be categorised as follows: (1) choosing the study question and design, (2) estimating clinical effectiveness; (3) choosing cost data sources, and (4) reporting and dissemination of results. Each of these is discussed while focusing on vaccines. In addition a case study is presented on two contemporary economic evaluations of pneumococcal conjugate vaccination for Canada. Though they are quite similar in design and methods, their results are not quite so. This paper explores the differences between them in relation to the four areas of bias. Finally, remedies to avoid bias in research and publications are proposed and discussed.