Critique: review on Economic Benefits of sharing and Redistributing influenza vaccines when Shortages occurred.
Author: Sheng-IChen
Published: October 17, 2017
Background:
Recurrent influenza outbreak has been a concern for government health institutions in Taiwan.
Over 10% of the population is infected by influenza viruses every year, and the infection has caused losses to both health and the economy.
Approximately three million free vaccine doses are ordered and administered to high-risk populations at the beginning of flu season to control the disease.
The government recommends sharing and redistributing vaccine inventories when shortages occur.
While this policy intends to increase inventory flexibility and has been proven as widely valuable, its impact on vaccine availability has not been previously reported.
Source: https://pubmed.ncbi.nlm.nih.gov/29040317/
Critique:
The article discussed the proposed four policies as to avoid shortage and overstock of vaccines and how will the economy be benefited from these policies.
Policy 1 - No sharing and redistributing vaccines (baseline), Assuming that that vaccines are stock in 22 counties separately. Furthermore, pediatric and adult vaccines can only apply to specific age group population.
Policy 2 – Sharing vaccines, formulation of the policy for sharing pediatric and adult vaccines. Suppose that both vaccine types can be administered to all age group populations when one of the vaccine types is out of stock. A child younger than 3 years old uses half-doses of an adult vaccine, and the remaining half doses are discarded.
Policy 3 - Redistributing vaccines. This policy allows vaccine inventories to be redistributed within different locations, yet pediatric and adult vaccines are not shared among both age group populations. Another implication of this policy may refer to the centralized inventory system, where vaccines are kept in a warehouse and then delivered to demand sites as requested.
Lastly, Policy 4 - Combination of sharing and redistributing vaccines, this policy allows demands to be fulfilled by inventories, regardless of vaccine types and locations.
As a result, the policies were compared by dividing the expected value of baseline policy (P1) by each expected result of new policies (P2), (P3), and (P4), and then subtracting by one. The reduction percentage is to measure the potential cost saving when the new policy is implemented.
A higher value indicates a more effective policy in terms of averting vaccine unavailability and unused. The author also studied the production of vaccines. Scenarios such as regular vaccine supply, insufficient vaccine supply (25% less than demands), and excessive vaccine supply (25% greater than demands).
The sharing, redistributing, or a combination of these policies can help the immunization program to allocate vaccine availabilities and reduce vaccine waste.
Through these policies, the citizens can have better access to vaccines provided by the government.
The vaccine may have an indefinite number of supplies, it may be excessive or sufficient.
These scenarios may be considered when to substitute or to distribute to other locations to supply different demand groups.
The author analyzed the three scenarios namely, regular vaccine supply, excessive vaccine supply, and insufficient vaccine supply applying the policies.
When vaccine supply was as the expected demand, the redistributing policy experienced greater reductions in both unavailability and overstock than the sharing policy.
The sharing policy performed better than the redistributing policy in other scenarios.
Although no evidence that either sharing policy or redistributing policy has the best remedy, a combination of these policies obtained the best result.
I believe and agree that these policies may also mitigate the effect of demand uncertainty on the overall performance.
This study also helps the inventory management of the government and also to assess the benefit of the government’s new policies.
Currently, the Taiwanese government only recommends sharing leftover adult vaccines for unmet pediatric demands.