Exploratory Research On Engineering The Service Sector: Collaborative Research: Research on Designing Vaccine Formularies for Childhood Immunization

儿童接种疫苗已成为美国儿童对抗传染病的最大单一防御措施。此外，生物技术的突破使疫苗制造商有可能开发出针对多种疾病的疫苗抗原。这种创新的一个意外后果是，建议的儿童免疫接种时间表(由免疫做法咨询委员会制定)变得足够拥挤，因此在该时间表上增加疫苗(因此增加注射)的前景可能不会受到保健提供者或父母/监护人的欢迎。这促使疫苗制造商开发出将几种抗原组合成一针的疫苗产品。这种疫苗被称为联合疫苗，允许在不给父母/监护人造成额外负担的情况下将新疫苗添加到时间表中，也不要求儿童在单一诊所就诊期间忍受不可接受的注射次数。这些创新还为卫生保健提供者创造了一种组合爆炸式的选择，随着更多疫苗被添加到免疫计划中，以及新的组合疫苗获得批准分发，这种选择将继续升级和扩大。该项目的目标是设计操作研究模型，以获取目前在推荐的儿童免疫计划中的所有疫苗以及未来十年可能进入该计划的疫苗，制定和分析可用于确定新的组合疫苗产品为医疗保健消费者提供良好价值的最高价格的优化模型，并进行敏感性分析以确定新疫苗对最优疫苗配方和疫苗价格的影响。本研究的结果为在推荐的儿童免疫计划内比较和评估现有的和新的儿科疫苗提供了一种系统的方法。反过来，这将提供一种工具，在此基础上可以使用运筹学模型来评估新疫苗和疫苗组合的机会，因此在现有疫苗选择的情况下，有可能提高免疫接种率。此外，开发的工具将提供一种机制，使卫生保健提供者和消费者能够评估这类疫苗的经济价值，从而促进在儿科疫苗行业内应用市场原则。这反过来也可能给这类疫苗的价格带来下行压力，这是一个举国关注的重大问题。这项研究将与疾病控制和预防中心(CDC)国家免疫计划内的人员合作进行。

Childhood vaccination has become the single greatest defense against infectious diseases among children in the United States. Moreover, biotechnology breakthroughs are making it possible for vaccine manufacturers to develop vaccine antigens for numerous diseases. One unplanned consequence of such innovations is that the Recommended Childhood Immunization Schedule (as set forth by the Advisory Committee on Immunization Practices) has become sufficiently crowded that the prospect of adding additional vaccines (hence additional injections) to this schedule may not be well received by either health-care providers or parents/guardians. This has prompted vaccine manufacturers to develop vaccines products that combine several antigens into a single injection. Such vaccines, termed combination vaccines, permit new vaccines to be added to the schedule without placing additional burdens on parents/guardians, nor requiring children to endure an unacceptable number of injections during single clinic visits. Such innovations have also created a combinatorial explosion of choices for health-care providers that will continue to escalate and expand as additional vaccines are added to the immunization schedule and as new combination vaccines gain approved for distribution. The goals of this project are to design operations research models that capture all the vaccines that are presently in the recommended childhood immunization schedule, as well as vaccines that may enter the schedule over the next decade, to formulate and analyze optimization models that can be used to determine the maximal price at which new combination vaccine products provide good value to the health-care consumer, and to perform sensitivity analysis to determine the impact of new vaccines on the optimal vaccine formularies and vaccine prices.The results of this research provide a systematic approach to compare and evaluate existing and new pediatric vaccines within the recommended childhood immunization schedule. This, in turn, will provide a vehicle upon which opportunities for new vaccines and vaccine combinations can be evaluated using operations research models, hence has the potential to enhance immunization rates given the set of vaccine choices available. Moreover, the tools developed will provide a mechanism by which health-care providers and consumers can assess the economic value of such vaccines, hence facilitating the application of market principles within the pediatric vaccine industry. This in turn may also serve to put downward pressure on the prices of such vaccines, an issue of significant national concern. This research will be conducted in collaboration with personnel within the National Immunization Program at the Center for Disease Control and Prevention (CDC).