Sources and Characteristics of Utility Weights for Economic Evaluation of Pediatric Vaccines: A Systematic Review

Value Health. 2016 Mar-Apr;19(2):255-66. doi: 10.1016/j.jval.2015.11.003. Epub 2015 Dec 29.


Background: Cost-effectiveness analysis of pediatric vaccines for infectious diseases often requires quality-of-life (utility) weights.

Objective: To investigate how utility weights have been elicited and used in this context.

Methods: A systematic review was conducted of studies published between January 1990 and July 2013 that elicited or used utility weights in cost-effectiveness analyses of vaccines for pediatric populations. The review focused on vaccines for 17 infectious diseases and is presented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

Results: A total of 6410 titles and abstracts and 225 full-text articles were reviewed. Of those selected for inclusion (n = 101), 15 articles described the elicitation of utility weights and 86 described economic modeling studies using utilities. Various methods were used to generate utilities, including time trade-off, contingent valuation, and willingness to pay, as well as a preference-based measure with associated value sets, such as the EuroQol five-dimensional questionnaire or the Health Utilities Index. In modeling studies, the source of utilities used was often unclear, poorly reported, or based on weak underlying evidence. We found no articles that reported on the elicitation or use of utilities in diphtheria, polio, or tetanus.

Conclusions: The scarcity of appropriate utility weights for vaccine-preventable infectious diseases in children and a lack of standardization in their use in economic assessments limit the ability to accurately assess the benefits associated with interventions to prevent infectious diseases. This is an issue that should be of concern to those making decisions regarding the prevention and treatment of infectious childhood illnesses.

Keywords: infectious diseases; literature review; pediatric; utilities; vaccine-preventable.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • Drug Costs*
  • Female
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Health Status
  • Health Status Indicators
  • Humans
  • Immunization Schedule
  • Infant
  • Infant, Newborn
  • Male
  • Models, Economic
  • Pediatrics / economics*
  • Quality of Life
  • Quality-Adjusted Life Years
  • Risk Assessment
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vaccination / adverse effects
  • Vaccination / economics*
  • Vaccines / administration & dosage*
  • Vaccines / adverse effects
  • Vaccines / economics*


  • Vaccines