定义和方法方法的差异阻碍了跨多个健康领域的经济评估结果的比较和综合,包括免疫。应世界卫生组织(WHO)免疫和疫苗相关实施研究咨询委员会(IVIR-AC)的要求,世卫组织召集了一个疫苗交付成本核算特设工作组,由从事免疫费用计算的八个组织的专家组成,以解决缺乏标准化以及定义和方法指导方面的差距。工作组的目的是制定一项共识声明,统一术语和原则,并为决策提供疫苗交付成本建议。本文论述了这一过程,审查结果,以及《共识声明》中的建议。
工作组进行了多次访谈,电话会议,和一次面对面会议,以确定从事疫苗交付成本计算的小组以及现有的指导文件和成本计算工具,侧重于低收入和中等收入国家环境。然后,他们审查了成本计算目标,观点,terms,方法,和这些文件中的原则。起草了共识声明原则,以与全球卫生成本集团成本计算指南保持一致,作为商定的规范性参考,起草了共识定义,以反映所审查文件的主要观点。
工作组确定了关于疫苗交付成本核算的四个主要工作流程,以及9个指导文件和11个免疫成本核算工具。他们发现,一些术语和原则是普遍定义的,而另一些则特定于单个工作流。基于这些发现和广泛的咨询,提出了协调术语和原则差异的建议。
使用共识声明中概述的标准化原则和定义,可以促进全球范围内对经济证据的解释,区域,和国家决策者。提高免疫等卫生服务方案成本计算的方法一致性和清晰度,对于支持循证政策和最佳资源分配非常重要。另一方面,这种审查和共识声明的发展过程揭示了我们协调能力的局限性,因为研究设计将根据正在解决的政策问题和国家背景而有所不同。
Differences in definitions and methodological approaches have hindered comparison and synthesis of economic evaluation results across multiple health domains, including immunization. At the request of the World Health Organization\'s (WHO) Immunization and Vaccines-related Implementation Research Advisory Committee (IVIR-AC), WHO convened an ad hoc Vaccine Delivery Costing Working Group, comprising experts from eight organizations working in immunization costing, to address a lack of standardization and gaps in definitions and methodological guidance. The aim of the Working Group was to develop a
consensus statement harmonizing terminology and principles and to formulate recommendations for vaccine delivery costing for decision making. This paper discusses the process, findings of the review, and recommendations in the
Consensus Statement.
The Working Group conducted several interviews, teleconferences, and one in-person meeting to identify groups working in vaccine delivery costing as well as existing guidance documents and costing tools, focusing on those for low- and middle-income country settings. They then reviewed the costing aims, perspectives, terms, methods, and principles in these documents.
Consensus statement principles were drafted to align with the Global Health Cost Consortium
costing guide as an agreed normative reference, and
consensus definitions were drafted to reflect the predominant view across the documents reviewed.
The Working Group identified four major workstreams on vaccine delivery costing as well as nine guidance documents and eleven
costing tools for immunization
costing. They found that some terms and principles were commonly defined while others were specific to individual workstreams. Based on these findings and extensive consultation, recommendations to harmonize differences in terminology and principles were made.
Use of standardized principles and definitions outlined in the Consensus Statement within the immunization delivery costing community of practice can facilitate interpretation of economic evidence by global, regional, and national decision makers. Improving methodological alignment and clarity in program costing of health services such as immunization is important to support evidence-based policies and optimal resource allocation. On the other hand, this review and Consensus Statement development process revealed the limitations of our ability to harmonize given that study designs will vary depending upon the policy question that is being addressed and the country context.