A new scoping review in BMJ Open looks at how low- and middle-income countries (LMICs) can strengthen the use of economic evidence—like cost-effectiveness and budget impact—to guide vaccine policy and prioritization when resources are constrained. The authors reviewed English-language literature (2004–December 16, 2024) identified through PubMed, HINARI, and DOAJ, and synthesized 18 eligible papers.
The headline finding is a persistent evidence-to-decision gap: economic evidence was systematically requested and clearly influenced vaccine introduction or prioritization in only 8 of 32 LMIC settings with functional National Immunization Technical Advisory Groups (NITAGs), and in fewer than 20% of documented new vaccine introductions since 2015. In many cases, decisions were reported as being driven more by disease burden, political priority, donor recommendations, or historical precedent—with economic analyses absent, produced after decisions, or not decisive. The authors point to practical ways forward, emphasizing stronger NITAG capacity and independence, closer collaboration with researchers, and tailored adaptations such as simplified cost-effectiveness tools and regional economic data hubs to make economic evidence easier to generate, interpret, and use in real policy timelines.
Thumbnail image credit: Gavi/2024/Mulugeta Ayene
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