Health economics of vaccine preventable diseases in selected low and middle-income countries
21 March 2019
University of Antwerp, Hof van Liere, F. de Tassis hall - Prinsstraat 13 - 2000 Antwerp (route: UAntwerpen, Stadscampus
Carlos Lara Oliveros
Prof Diana De Graeve
PhD defence Carlos Lara Oliveros - Faculty of Business and Economics
From a health economics perspective, this thesis presents evidence-based considerations for decision-making, including the quantification of the economic and disease burden, the economic evaluation of vaccine intervention strategies, and the analysis of determinants of the supply and demand for vaccines. More specifically, it contributes to the body of knowledge of the health economics of vaccine preventable diseases in low and middle-income countries (LMICs), for which there are important knowledge gaps. The aims of the thesis are to increase the body of knowledge on LMICs with special attention to Colombia, and to propose explanations for the continued high economic and disease burden despite efforts to facilitate access to vaccines especially for vulnerable populations.
We also contribute to the existing literature by improving the estimations of the related costs per episode of acute respiratory infections and by generating input parameters for future studies. For the specific case of Colombia, we recommend to the national health authorities improvements in the timing of the administration of the influenza vaccine. In addition, we provide national authorities with some points for consideration when deciding the introduction of a new vaccine by performing cost effectiveness analyses for Albania, Colombia and Egypt. We also elucidate the vaccination determinants for LMICs with a subsidized health care system especially in the case of Colombia. We therefore recommend to health authorities to consider the inclusion of targeted programs in their vaccination strategies. Overall, we hope this thesis demonstrates that decision-making for the optimal allocation of resources for strengthening vaccination strategies is complex and should consider many perspectives.