Recommendations to improve the evidence base of public health policies by transferring economic models of vaccination programs to lower income European countries

Objective Implementation of evidence-based public health policies is lagging in lower income European countries (LIECs). This study aimed to explore barriers of transferring economic models of vaccination programs to LIECs and make recommendations on how to overcome these barriers. Methods This work took place in the context of the VITAL IMI project, part of which aimed to explore how to transparently and effectively measure and report the full economic impact of current and future infectious disease management in ageing adults. Transferability aspects were considered from the beginning of the project. An economic model was developed to judge the value of influenza vaccination for elderly people. The adaptation process to the Netherlands, Hungary and Serbia indicated generalizable barriers. In two workshops the initially listed barriers were validated and ranked, then recommendations were made on how to facilitate the transferability of economic models to LIECs. Results Key barriers of transferring economic models to LIECs were limited interest in or understanding of using HTA evidence in public health policy decisions and lack of available data or financial resources for the local adaptation of international economic models. To address 8 perceived barriers 21 recommendations were made. While some recommendations require significant investment, others require only sufficient upfront attention. Conclusions As LIECs adopt new technologies relatively late, they can benefit from available models and real-world data from early technology adopter countries. To increase public health preparedness by transferring economic models of vaccination programmes requires a carefully designed approach, which can be facilitated by considering our general recommendations.