Warren T A, Finder S F, Brier K L, Ries A J, Weber M P, Miller M R, Potyk R P, Reeves C S, Moran E L, Tornow J J
Wilford Hall Medical Center, Department of Pharmacy, Lackland Air Force Base, Texas, USA.
Pharmacoeconomics. 1996 Nov;10(5):475-83. doi: 10.2165/00019053-199610050-00005.
Typhoid fever has been a problem for military personnel throughout history. A cost-effectiveness analysis of typhoid fever vaccines from the perspective of the US military was performed. Currently 3 vaccine preparations are available in the US: an oral live Type 21A whole cell vaccine; a single-dose parenteral, cell subunit vaccine; and a 2-dose parenteral heat-phenol killed, whole cell vaccine. This analysis assumed all vaccinees were US military personnel. Two pharmacoeconomic models were developed, one for personnel who have not yet been deployed, and the other for personnel who are deployed to an area endemic for typhoid fever. Drug acquisition, administration, adverse effect and lost work costs, as well as the costs associated with typhoid fever, were included in this analysis. Unique military issues, typhoid fever attack rates, vaccine efficacy, and compliance with each vaccine's dosage regimen were included in this analysis. A sensitivity analysis was performed to test the robustness of the models. Typhoid fever immunisation is not cost-effective for US military personnel unless they are considered imminently deployable or are deployed. The most cost-effective vaccine for US military personnel is the single-dose, cell subunit parenteral vaccine.
在历史上，伤寒热一直是军事人员面临的一个问题。从美国军方的角度对伤寒热疫苗进行了成本效益分析。目前美国有3种疫苗制剂：口服活21A全细胞疫苗；单剂量肠胃外细胞亚单位疫苗；以及两剂量肠胃外热酚灭活全细胞疫苗。该分析假定所有接种疫苗者均为美国军事人员。开发了两个药物经济学模型，一个针对尚未部署的人员，另一个针对部署到伤寒热流行地区的人员。该分析包括药物采购、给药、不良反应和误工成本，以及与伤寒热相关的成本。该分析还包括独特的军事问题、伤寒热发病率、疫苗效力以及每种疫苗给药方案的依从性。进行了敏感性分析以测试模型的稳健性。对于美国军事人员来说，伤寒热免疫接种不具有成本效益，除非他们被认为即将被部署或已经被部署。对美国军事人员来说，最具成本效益的疫苗是单剂量细胞亚单位肠胃外疫苗。
