The government is consulting on proposed changes to the methodology used to decide the cost-effectiveness of vaccination programmes in England.
The consultation, which opened on 26 February 2018 and runs until 21 May, comes as a government working group has warned that some of the 27 proposals, if agreed, would introduce “fundamental changes” that could have an impact on which vaccines are approved and their price.
The recommendations out for consultation come from the Cost-Effectiveness Methodology for Immunisation Programmes & Procurement (CEMIPP) group of the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI is the independent expert committee that advises ministers on changes to UK vaccination programmes as well as the introduction of new programmes.
The CEMIPP proposals, originally published in 2016, include lowering the cost-effectiveness threshold and the discount rates for health impact. There is also a proposal to introduce “an indefinite time horizon of analysis (that is the time period over which impacts of a vaccine are considered), with the inclusion of a sensitivity test to account for a lower discount rate”.
These three recommendations were described as “fundamental changes” by the Department of Health and Social Care’s appraisal alignment working group when it considered the CEMIPP proposals.
The working group warned: “Implementation of the recommendations would likely lead to a lowering of the cost-effective price for vaccines. This would make it less likely for vaccines to be deemed cost-effective and approved at current prices.
“How this then affects costs and/or decisions on which vaccines are procured is less certain, as the price paid by the government is a factor of both the cost-effective price and the commercial environment for each vaccine.”
The government is particularly keen to seek the views of health economists on the CEMIPP proposals before making its final decision.
Its consultation report said: “The issues and the recommendations are necessarily complex and technical. We are therefore particularly looking for views from organisations and committees that appraise cost-effectiveness within the health and care sector as well as specialists with an interest in health economics such as health-economists based in academia, public health practitioners, epidemiologists, charities and patient groups, clinicians and vaccine industry professionals.”