Rachel A Archer1, Ritika Kapoor2, Wanrudee Isaranuwatchai1,3, Yot Teerawattananon1,2, Birgitte Giersing4, Siobhan Botwright4, Jos Luttjeboer5,6, Raymond C W Hutubessy4. 1. Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand. 2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. 3. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. 4. Immunization, Vaccines and Biologicals Department, World Health Organization, Geneva, Switzerland. 5. Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 6. Asc Academics, Groningen, The Netherlands.
Abstract
BACKGROUND: Despite a growing global commitment to universal health coverage, considerable vaccine coverage and uptake gaps persist in resource-constrained settings. One way of addressing the gaps is by ensuring product innovation is relevant and responsive to the needs of these contexts. Total Systems Effectiveness (TSE) framework has been developed to characterize preferred vaccine attributes from the perspective of country decision-makers to inform research and development (R&D) of products. A proof of concept pilot study took place in Thailand in 2018 to examine the feasibility and usefulness of the TSE approach using a rotavirus hypothetical test-case. METHODS: The excel-based model used multiple-criteria decision analysis (MCDA) to compare and evaluate five hypothetical rotavirus vaccine products. The model was populated with local data and products were ranked against decision criteria identified by Thai stakeholders. A one-way sensitivity analysis was performed to identify criteria that influenced vaccine ranking. Self-assessment forms were distributed to R&D stakeholders on the usability of the approach and were subsequently analysed. RESULTS: The model identified significant parameters that impacted on MCDA rankings. Self-assessment forms revealed that TSE was perceived as being able to encourage closer collaboration between country decision makers and vaccine developers. CONCLUSIONS: The pilot study demonstrates that it is feasible to use an MCDA approach to elicit stakeholder preferences and determine influential parameters to help identify the preferred product characteristics for R&D from the perspective of country decision-makers. It found that TSE can help steer manufacturers to develop products that are better aligned with country need. Findings will guide further development of the TSE concept.
BACKGROUND: Despite a growing global commitment to universal health coverage, considerable vaccine coverage and uptake gaps persist in resource-constrained settings. One way of addressing the gaps is by ensuring product innovation is relevant and responsive to the needs of these contexts. Total Systems Effectiveness (TSE) framework has been developed to characterize preferred vaccine attributes from the perspective of country decision-makers to inform research and development (R&D) of products. A proof of concept pilot study took place in Thailand in 2018 to examine the feasibility and usefulness of the TSE approach using a rotavirus hypothetical test-case. METHODS: The excel-based model used multiple-criteria decision analysis (MCDA) to compare and evaluate five hypothetical rotavirus vaccine products. The model was populated with local data and products were ranked against decision criteria identified by Thai stakeholders. A one-way sensitivity analysis was performed to identify criteria that influenced vaccine ranking. Self-assessment forms were distributed to R&D stakeholders on the usability of the approach and were subsequently analysed. RESULTS: The model identified significant parameters that impacted on MCDA rankings. Self-assessment forms revealed that TSE was perceived as being able to encourage closer collaboration between country decision makers and vaccine developers. CONCLUSIONS: The pilot study demonstrates that it is feasible to use an MCDA approach to elicit stakeholder preferences and determine influential parameters to help identify the preferred product characteristics for R&D from the perspective of country decision-makers. It found that TSE can help steer manufacturers to develop products that are better aligned with country need. Findings will guide further development of the TSE concept.
Authors: Siobhan Botwright; Anna-Lea Kahn; Raymond Hutubessy; Patrick Lydon; Joseph Biey; Abdoul Karim Sidibe; Ibrahima Diarra; Mardiati Nadjib; Auliya A Suwantika; Ery Setiawan; Rachel Archer; Debra Kristensen; Marion Menozzi-Arnaud; Ado Mpia Bwaka; Jason M Mwenda; Birgitte K Giersing Journal: Vaccine X Date: 2020-10-06