As innovative technologies and biological treatment are becoming available for use, policymakers worldwide will require a tool to evaluate the cost and assess the trade-offs. The concept of Total System Effectiveness (TSE) is an end-to-end analytical framework which is intended to inform future investments, purchase and advance the uptake of innovative medicine delivery technologies. The TSE is a step ahead, it is an approach to priority setting; Using HTA to inform the forthcoming products and apprise manufacturers of the demand specific characteristics that a product should have. The aim of TSE is to ensure that vaccine product preferences in low and middle-income countries inform R&D, with the intention of facilitating country uptake and decreasing risk for manufacturers. Decision making is a multifaceted process and involves a variety of stakeholders. The intent of TSE is to improve decision making at all levels from product development to in-country use by initiating a dialogue between the vaccine producers and health care programmes.
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