Economics of HIV Vaccines and HIV Vaccine Research and Development
Abstract
This thesis explores the economics of a prospective human immunodeficiency virus (HIV) vaccine in terms of: a) its cost-effectiveness in South Africa, and b) the opportunity cost of diverting vaccine R&D funds from other HIV prevention and control activities in South Africa. First, I use a mathematical and economic model of HIV vaccination in South Africa, exploring the cost-effectiveness of HIV vaccines with different attributes. I find that 1) vaccines with moderate initial efficacy but longer durations and smaller decay rates may have the same cost-effectiveness as a vaccine with high initial efficacy but short duration; 2) the vaccine’s cost-effectiveness decreases only slightly with higher vaccine coverage but dramatically with lower prevalence rate; and 3) more than one-third of the total benefit of a vaccine comes from its positive externality.Second, I compare the HIV vaccination as a potential preventive intervention versus PrEP. I find that 1) a vaccine with 60% initial efficacy, an 8-year duration, and a decay rate of γ = 3 is less effective than PrEP in reducing HIV prevalence and incidence from 2021 to 2035; 2) if PrEP has an efficacy of 90%, then we should charge a Thai Trial vaccine below $63, and an HVTN702 vaccine below $100 to make it preferable to PrEP.
Finally, I examine the economic return on investing in R&D of an HIV vaccine, by comparing the return (in terms of infections averted) to the same level of investment into increasing uptake of existing HIV preventive interventions instead (ART, MMC and PrEP). I find that 1) the attributes of an HIV vaccine, and the probability of realizing them through R&D investment, determines the attractiveness of such investment relative to spending on alternative HIV interventions; and 2) a vaccine is much more preferable if the initial coverage of alternative interventions is higher.
Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:37945602
Collections
Contact administrator regarding this item (to report mistakes or request changes)