OBJECTIVES : The COVID-19 pandemic shows that the impact of effective vaccines extends well beyond vaccinated individuals and healthcare systems. While the importance of these externalities is broadly recognised by health economists, they are not typically considered in HTA. This may underestimate vaccines’ broader value and lead to suboptimal allocation decisions. Hence, the objectives of this study were to: 1) prioritise elements of broader value that are most important a/o feasible to be incorporated in vaccine assessments; (2) identify critical challenges and opportunities for including these broader value elements in HTA; 3) explore ways to overcome these including data, methods and policy advancements needed.

METHODS : A modified Delphi-approach including two online survey rounds plus an expert roundtable. The Delphi-panel included nine experts: six academic HTA/vaccine assessment experts, two consultants with treasury and civil service experience, and one industry representative.

RESULTS : Prioritised value elements include transmission value, vaccinee/patient productivity, carer productivity, carer quality of life, and prevention of antimicrobial resistance. In addition, health system delivery value was proposed while enablement value was deprioritised for lacking a clear definition. Availability of data is the main barrier for most broader value elements, while progress is made on analytic methods. As the COVID-19 pandemic has provided urgency and a political climate to recognise the broader value of vaccines, though more systemic change is required as experts agreed that broader value elements should be considered for all health technologies.

CONCLUSIONS : Fully recognising the broader value of vaccines requires the incorporation of various value elements that are currently not consistently considered in HTA processes in England. Achieving this requires sufficient incentives to invest in evidence generation. A shared understanding of the implications of broader value assessment on cost-effectiveness thresholds, discount rates, equity, and other fundamental aspects of HTA is needed.