Comparison criteria: Difference between revisions

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== Question ==
== Question ==


Which comparison criteria should be used for pneumococcal conjugatevaccines in the tendering process in the autumn of 2014, in which(?) a vaccine is aquired for the national vaccination programme for children?
Which comparison criteria should be used in the tendering process for the selection of a pneumococcal conjugate vaccine within the national vaccination programme for children in Finland? The tendering process will be initiated during the autumn of 2014.
* Possible comparison criteria include prize, benefits(?), safety and technical properties.
 
** Prize refers to the bargaining prize of the vaccine.
* Possible comparison criteria include price, effectiveness, safety and technical properties.
** Benefits refers to the decrease in desease burden caused by large scale use of the vaccine. As a result the quality of life connected to health increases and health care costs decrease.
** Price refers to the bargaining price of the vaccine.
** Effectiveness refers to the decrease in disease burden caused in the total Finnish population by large scale use of the vaccine in the infant programme. As a result health care costs decrease and the quality of life attributed to improved health increases.
** Safety
** Safety
** Technical properties
** Technical properties
* The benefits of the pneumococcal conjugate vaccine can be assessed by the decrease of desease caused by pneumococcus and Haemophilus influenzae -bacteria.
* The benefit is assessed in the entire Finnish population.


== Answer ==
== Answer ==


The original proposal is that the comparison of the vaccines will concentrate on the prize and the assessed benefits. Benefit is assessed according to invasive pneumococcal deseases. Hyötyä arvioidaan invasiivisen pneumokokkitaudin perustella.
The proposal is that the comparison of vaccine products will be based on price only (see [[Economic_evaluation|Economic_evaluation]].
This is based on the expected small difference in the effectiveness and costs incurred between the two licensed vaccines, when effectiveness was based on prevention of invasive pneumococcal disease. The importance of including other endpoints than invasive disease
is acknowledged, however, due to lack sufficient data on vaccine-preventable (serotype-specific) incidences, such analyses were not conducted so far.
 
== Rationale ==
 
According to the public procurement law, comparison criteria related to differences in the products can be applied  if (1) the differences are clearly demonstrated and (2) the differences can be quantified in terms of increased or decreased benefits. In particular, technical differences typically fall outside of this realm. So far no credible differences in safety among the currently licensed pneumococcal conjugate vaccines have been demonstrated.


This original proposal is the basis for the conversation beginning in the summer of 2014.
To assess the health benefits of vaccination, the following items needs to be known or assessed:
* pneumococcal serotypes included in the vaccine
* decrease in the pneumococcal disease incidences due to vaccination
* the potential protection of the vaccine against disease caused by the bacterium ''Haemophilus influenzae''


== Rationale ==
The tentative assumption is that the use of either the 10-valent (PCV10) or 13-valent (PCV13) pneumococcal conjugate vaccine (PCV) in the childhood immunization programme significantly reduces the disease incidence attributable to the serotypes included in the vaccine and that this protection extends to the population at large. This assumption may be modified so that the vaccine also reduces disease incidence caused by certain serotypes not included in the vaccine (due to cross-protection). The predicted reduction in invasive pneumococcal disease due to vaccination is calculated using an epidemiological model.


The procurement law(?) only allows clearly demonstrated differences proportionable to the benefits of products as comparison criteria. Practirally often especially so called technical differences cannot be taken into account. There have been no differences in the safety demonstrated in licenced pneumococcal conjugate vaccines.
The vaccine-preventable pneumococcal disease incidence used in the model is assumed to correspond to
proven (blood culture-positive) invasive pneumococcal disease.
In view of recent knowledge <ref>Palmu AA, Jokinen J, Nieminen H, Syrjänen R, Ruokokoski E, Puumalainen T, Moreira M, Schuerman L, Borys D, Kilpi TM. Vaccine effectiveness of the pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against clinically suspected invasive pneumococcal disease: a cluster-randomised trial. Lancet Respir Med. 2014 (9):717-27.</ref> and
if deemed feasible,  also estimates
of non-laboratory-confirmed IPD among children under 5 years of age can be included.
For other pneumococcal disease endpoints, reliable estimates of the vaccine-preventable disease incidences are not available.
Therefore, criteria or endpoints that should be considered are a) price, b) invasive pneumococcal disease, and c) technical criteria. However, if there were enough reliable data, also pneumonia and other respiratory endpoints should be included. Otitis media should be included at least as a sensitivity analysis.{{reslink|Health endpoints to consider}}


== See also ==
== See also ==


{{pneumococcal vaccine}}
{{pneumococcal vaccine}}
== References ==
<references/>
== Related files ==
* {{#l:GSK 02  Comparison criteria_final_for Opasnet.docx}}
== Comment the content ==
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Latest revision as of 11:18, 23 March 2016

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Question

Which comparison criteria should be used in the tendering process for the selection of a pneumococcal conjugate vaccine within the national vaccination programme for children in Finland? The tendering process will be initiated during the autumn of 2014.

  • Possible comparison criteria include price, effectiveness, safety and technical properties.
    • Price refers to the bargaining price of the vaccine.
    • Effectiveness refers to the decrease in disease burden caused in the total Finnish population by large scale use of the vaccine in the infant programme. As a result health care costs decrease and the quality of life attributed to improved health increases.
    • Safety
    • Technical properties

Answer

The proposal is that the comparison of vaccine products will be based on price only (see Economic_evaluation. This is based on the expected small difference in the effectiveness and costs incurred between the two licensed vaccines, when effectiveness was based on prevention of invasive pneumococcal disease. The importance of including other endpoints than invasive disease is acknowledged, however, due to lack sufficient data on vaccine-preventable (serotype-specific) incidences, such analyses were not conducted so far.

Rationale

According to the public procurement law, comparison criteria related to differences in the products can be applied if (1) the differences are clearly demonstrated and (2) the differences can be quantified in terms of increased or decreased benefits. In particular, technical differences typically fall outside of this realm. So far no credible differences in safety among the currently licensed pneumococcal conjugate vaccines have been demonstrated.

To assess the health benefits of vaccination, the following items needs to be known or assessed:

  • pneumococcal serotypes included in the vaccine
  • decrease in the pneumococcal disease incidences due to vaccination
  • the potential protection of the vaccine against disease caused by the bacterium Haemophilus influenzae

The tentative assumption is that the use of either the 10-valent (PCV10) or 13-valent (PCV13) pneumococcal conjugate vaccine (PCV) in the childhood immunization programme significantly reduces the disease incidence attributable to the serotypes included in the vaccine and that this protection extends to the population at large. This assumption may be modified so that the vaccine also reduces disease incidence caused by certain serotypes not included in the vaccine (due to cross-protection). The predicted reduction in invasive pneumococcal disease due to vaccination is calculated using an epidemiological model.

The vaccine-preventable pneumococcal disease incidence used in the model is assumed to correspond to proven (blood culture-positive) invasive pneumococcal disease. In view of recent knowledge [1] and if deemed feasible, also estimates of non-laboratory-confirmed IPD among children under 5 years of age can be included. For other pneumococcal disease endpoints, reliable estimates of the vaccine-preventable disease incidences are not available. Therefore, criteria or endpoints that should be considered are a) price, b) invasive pneumococcal disease, and c) technical criteria. However, if there were enough reliable data, also pneumonia and other respiratory endpoints should be included. Otitis media should be included at least as a sensitivity analysis.R↻

See also

Tendering process for pneumococcal conjugate vaccine
Parts of the assessment

Comparison criteria for vaccine   · Epidemiological modelling   · Economic evaluation

Background information

Sensitivity analysis · Replacement   · Pneumococcal vaccine products   · Finnish vaccination schedule   · Selected recent publications

Help for discussion and wiki editing

Pages in Finnish

Pneumokokkirokotteen hankinta  · Rokotteen vertailuperusteet · Epidemiologinen malli · Taloudellinen arviointi · Pneumokokkirokotteen turvallisuus

Work scheduling · Monitoring the effectiveness of the pneumococcal conjugate vaccine · Glossary of vaccine terminology


References

  1. ↑ Palmu AA, Jokinen J, Nieminen H, Syrjänen R, Ruokokoski E, Puumalainen T, Moreira M, Schuerman L, Borys D, Kilpi TM. Vaccine effectiveness of the pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against clinically suspected invasive pneumococcal disease: a cluster-randomised trial. Lancet Respir Med. 2014 (9):717-27.

Related files

Comment the content


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