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Although recall bias is often associated with self-report measures, studies have shown that resource utilization declines over time whereby patients have a tendency to under-report values resulting in a net underestimation of cost and utilization values [ 48, 49].
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For the case of megaprojects, overestimation of benefits and underestimation of costs and risks is a common problem all over the world, leading to the 'survival of the unfittest' (Flyvbjerg, 2009).
This means that the results of the economic evaluation suggest a probable underestimation of (cost- effectiveness of IRR.
There are certain limitations to our study which may have resulted in an underestimation of costs.
This may have led to an underestimation of costs at home, especially in UC.
It is likely that inadequately accounting for presenteeism in other studies contributed to underestimation of costs.
Regarding the estimation of drug costs, several assumptions were necessary that may have caused over- or underestimation of costs.
Regarding estimation of direct healthcare costs, several assumptions were necessary that may have caused over- or underestimation of costs.
With regard to costs, the prices for the smallest available package size (N1) were taken instead to estimate the potential underestimation of costs due to this assumption.
The underestimation of costs does have the advantage that it does not favour the vaccine arm and therefore represents a conservative approach.
Underestimation of costs and funding shortfalls can lead to SIA implementation delays, and can force implementers to target narrower age groups undermining efforts to reach program goals.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com