A systematic literature review of methodologies used in economic evaluations of combination vaccines

This systematic review examines the methodologies used in economic evaluations of combination vaccines. Based on a search across six databases, it synthesizes evidence from seven eligible studies published between 1999 and 2019, in high-income settings, identifying methodological gaps, and providing recommendations to strengthen future economic evaluations.

Highlights

• All included studies found the evaluated combination vaccines to be cost-effective or cost-saving, although results were influenced by modelling assumptions and comparator choice.
• Studies generally assumed equivalent efficacy between combination and single vaccines, with the added value of combination vaccines driven by protection against additional diseases, improved coverage, or fewer vaccination visits.
• All studies used static, deterministic models, and only one conducted a probabilistic sensitivity analysis to assess uncertainty.
• Studies varied considerably in how they captured clinical and economic outcomes, and broader societal value elements were not represented, suggesting the full value of combination vaccines may have been underestimated.
• Methodological and reporting quality varied considerably, with none of the studies fully meeting WHO or CHEERS quality standards.

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