Methodological framework for estimating the value of combination vaccines

As childhood immunization schedules become increasingly crowded, combination vaccines (which bundle multiple antigens into a single administration) are often promoted for their programmatic advantages—but they can also be costlier to develop and procure, making it harder for manufacturers and purchasers to align on price and value. A new methodological paper in PharmacoEconomics by Jit and colleagues proposes a practical framework to ensure that standard health economic evaluations capture the additional benefits combination products can generate beyond disease prevention alone. The authors argue that the value of combination vaccines can be quantified across four domains: reduced tangible and intangible costs for caregivers (including time, travel, and injection burden), operational efficiencies for health systems, the opportunity cost of limited slots in vaccination schedules, and the benefits of more streamlined schedules overall.

To show how the approach can be used in practice, the authors present a stylized case study comparing options for introducing a hypothetical new vaccine antigen: as an additional standalone injection, as a replacement for an existing dose, or as part of a combination product. The example illustrates how bringing caregiver burdens, delivery efficiencies, and schedule constraints into the same analytic frame can materially change the assessed value of a combination vaccine—and, in turn, inform how much additional price a decision-maker could justify paying relative to standalone formulations. The paper also highlights key evidence gaps that would make real-world application easier, including better synthesis of the value of vaccines already on the schedule and stronger data (especially outside high-income settings) on willingness-to-pay for fewer administrations