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Vaccines also have provided imunity against infectious diseases

such as measles, diphtheria, whooping cough, tetanus, rubella, umpe,

pneumoccal pneumonia, hepatitis B and rabies.

Analgesics

Aspirin-introduced just after the tum of the century

was the

first safe and effective non-narcotic analgesic, but its potency was

limited. Although analgesics do not cure or appreciably alter the course

of a disease, they can relieve pain and bring a sense of well-being in

the presence of disease.

The first non opiate drug to match the opium

alkaloids in analgesic potency was neperidine, synthesized in 1939. Some of the recently discovered non-steroidal anti-inflammatory drugs

also have excellent analgesic properties.

Cardiopancular Das

During the last 25 years, new medicines helped produce a

substantial reduction in the death rate for what had become the leading

killer in the United States and throughout the industrialized

worldcardiovascular disease.

In just the last 10 years, deaths from

strokes declined by 43 percent, while deaths from heart attacks decreased by 25 percent. New medicines, including the thiazide class of diuretic hypotensives, beta blockers and calcium antagonists, were

partly responsible for the improvement.

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than 50 other anti-cancer drugs have been developed. In late 1983, the National Cancer Institute reported that more than 50 percent of all

cancer patients are surviving for at least five years--up from 33 percent in the mid 1950s--and that most of this group are cured of the

disease.

Medicines have helped treat a wide range of other

diseases-- including mental Illnesses, epilepsy, diabetes, glaucoma and

Parkinson's disease--and, in all, have helped prolong and greatly

improve the quality of life for millions of people throughout the world.

REVIEW OF LITERATURE ON COST-EFFECTIVENESS OF VACCINES

(Reports 2 and 3)

Reviews of the literature on vaccines and vaccination programs both in developed and developing countries result in the same conclusion: their benefits generally exceed their costs, despite differences in evaluative approaches and in the data used.

Vaccines in Developed countries

In Report 2, Burton A. Weisbrod and John H. Huston of the

University of Wisconsin reviewed cost-effectiveness studies of 10

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even though the studies were conducted over many years--from 1963 to

1975-and in many regions of several countries Austria, Finland and the

United States.

of the two studies reporting results that can be

expressed in benefit-cost ratios, one found that benefits were more than

10 times costs over a nine-year period (a benefit-cost ratio of 10.4:1),

the other that benefits were almost five times costs over a six-year period (a benefit-cost ratio of 4.9:1). And in another study, benefits

were shown to exceed costs by $1.3 billion from 1963 to 1972.

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Mimps: Four evaluations of mumps vaccine found benefit-cost ratios

ranging from 3.6:1 to 7.4:1 as well as significant net benefits.

One

study, for example, calculated a net benefit of $5 million for each

cohort of 1 million children, while another found a net benefit of about

$50 per immunization.

Rubella:

Three studies found that benefits greatly exceeded costs

when rubella vaccine was routinely given to children.

For females from

2 to 12 years old, benefits ranged from eight to 27 times costs (that

is, benefit-cost ratios ranged from 8:1 to 27:1).

Pneumococcal Pneumonia: Four studies of pneumococcal vaccine concluded that benefits exceeded costs for persons in high-risk groups,

such as the elderly and chronically ill.

This conclusion was reached

even though no attenpt was made to include the value of lives saved by the vaccine. The benefits from imunizing low-risk groups were less

clear.

Bertussis:

There is only one evaluation of pertussis vaccine, and

it found that benefits exceeded costs by more than 150 percent.

The vaccine is given as part of the DPT (diphtheria, pertussis and

tetanus) trivalent vaccine, so the costs of patient and physician time

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for administering the vaccine are minimal.

The major costs arise from

1

the infrequent side effects of the vaccine, which can include

convulsions and encephalitis.

Adenovirus: A study of military recruits found that the benefits

of adenovirus vaccine exceeded costs by 1.56:1.

Tuberculosis:

The results of the studies of the BCG (bacille

Calmette Guerin) vaccination for tuberculosis are contradictory.

One

study, using Austrian data, found that the benefits of the vaccine

substantially exceeded costs regardless of the age of those vaccinated.

Another study, using British data, found that costs exceeded benefits

using a wide range of vaccine costs and many methods of treating

tuberculosis.

More than anything, the different findings of the two

studies probably reflect disparities in methodology.

Polig:

Two studies of polio vaccine found it cost-beneficial by a

ratio as great as 10:1, with net benefits estimated to be about $1

billion a year in the United States.

As with most vaccine studies (and,

in fact, all evaluations of medical technology), however, the social

benefits were understated because the better health of people for whom

the disease was prevented was not taken into account.

This is

especially significant in the case of polio because of the crippling

effects of the disease and the youth of its victims.

Influenza:

The evaluations of flu vaccine have focused on the

benefits and costs of vaccinating people in various age groups.

That is

because the consequences of contracting influenza appear to be related to age and to a person's health immediately before infection.

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