dc.contributor.advisor Bloom, David E. dc.contributor.author Chen, Simiao dc.date.accessioned 2018-12-20T13:45:14Z dash.embargo.terms 2018-11-01 dc.date.created 2018-05 dc.date.issued 2018-04-20 dc.date.submitted 2018 dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:37945602 * dc.description.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. dc.format.mimetype application/pdf dc.language.iso en dash.license LAA dc.subject Health Sciences, Public Health dc.subject Economics, General dc.title Economics of HIV Vaccines and HIV Vaccine Research and Development dc.type Thesis or Dissertation dash.depositing.author Chen, Simiao dash.embargo.until 2018-11-01 dc.date.available 2018-12-20T13:45:14Z thesis.degree.date 2018 thesis.degree.grantor Harvard T.H. Chan School of Public Health thesis.degree.level Doctoral thesis.degree.name Doctor of Science (SD) dc.contributor.committeeMember Canning, David dc.contributor.committeeMember Bärnighausen, Till dc.type.material text thesis.degree.department Global Health and Population dash.identifier.vireo http://etds.lib.harvard.edu/hsph/admin/view/221 dc.description.keywords Economics; HIV vaccine; cost effectiveness; HIV vaccine research and development; dash.author.email sic104@mail.harvard.edu
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