Scott W G, Scott H M
Wellington Polytechnic, New Zealand.
Pharmacoeconomics. 1996 Jan;9(1):51-60. doi: 10.2165/00019053-199609010-00006.
The objective of this study was to evaluate the costs and benefits of influenza vaccination for the population aged 65 years and over, from the perspectives of individuals and health insurers, government and society. The annual incremental direct medical costs and benefits of influenza vaccination (compared with the nonvaccination, or 'do nothing', option) were evaluated using New Zealand healthcare resource usage and unit cost data [in 1992 New Zealand dollars ($NZ); $NZ1 = $US0.5458, June 1992] applied to cohort studies reported in the literature. The costs and benefits to society as a result of vaccination of people aged 65 years and older (20% of people in this age group are currently vaccinated) were estimated to be: (i) additional direct medical costs of vaccination of $NZ1.42 million [$NZ17.78 per vaccination]; (ii) direct medical costs avoided of $NZ5.35 million ($NZ67.18 per vaccination); and (iii) net benefits of $NZ3.93 million ($NZ49.40 per vaccination). The direct medical costs avoided per dollar cost of vaccination were $NZ1.04 for individuals, $NZ4.69 for government and $NZ3.78 for society as a whole. If the vaccination uptake for this group is increased in 20% increments, the net benefit to society increases by a further $NZ3.93 million per year at each step. If the economic evaluation is extended to include vaccination of at-risk individuals under 65 years of age, net benefits to society increase by 15%. Influenza vaccination for people aged 65 years and over is cost effective from the perspective of society, government and the individual. If the vaccination rate for at-risk individuals in New Zealand could be increased to 60%, the net benefits reported in this study would increase by 200%. However, the costs of promotion and education to achieve this vaccination rate would need to be deducted from the net benefits. Strategies to increase the vaccination rate include altering the cost of vaccinations to the individual, intensifying education and promotion programmes, and changing the mode of delivery.
本研究的目的是从个人、健康保险公司、政府和社会的角度，评估65岁及以上人群接种流感疫苗的成本和效益。利用新西兰医疗资源使用情况和单位成本数据（以1992年新西兰元计；1992年6月，1新西兰元 = 0.5458美元），并将其应用于文献报道的队列研究，评估了流感疫苗接种（与未接种或“不采取任何措施”的选择相比）的年度增量直接医疗成本和效益。据估计，65岁及以上人群接种疫苗（该年龄组目前有20%的人接种）给社会带来的成本和效益为：（i）接种疫苗的额外直接医疗成本为142万新西兰元（每次接种17.78新西兰元）；（ii）避免的直接医疗成本为535万新西兰元（每次接种67.18新西兰元）；（iii）净效益为393万新西兰元（每次接种49.40新西兰元）。每接种1美元疫苗所避免的直接医疗成本，个人为1.04新西兰元，政府为4.69新西兰元，整个社会为3.78新西兰元。如果该年龄组的疫苗接种率以20%的增幅提高，社会的净效益在每一步都会进一步增加393万新西兰元。如果将经济评估扩大到包括65岁以下高危人群的疫苗接种，社会的净效益将增加15%。从社会、政府和个人的角度来看，65岁及以上人群接种流感疫苗具有成本效益。如果新西兰高危人群的疫苗接种率能够提高到60%，本研究报告的净效益将增加200%。然而，实现这一疫苗接种率的推广和教育成本需要从净效益中扣除。提高疫苗接种率的策略包括改变个人接种疫苗的成本、加强教育和推广计划以及改变接种方式。
