Postma M J, Heijnen M L, Jager J C
Groningen University Institute for Drug Exploration/Groningen Research Institute of Pharmacy (GUIDE/GRIP), Groningen, The Netherlands.
Pharmacoeconomics. 2001;19(2):215-22. doi: 10.2165/00019053-200119020-00008.
To assess the cost effectiveness (net costs per life year gained) of pneumococcal vaccination of elderly individuals aged 65 years and over in The Netherlands.
A pharmacoeconomic analysis was conducted from the healthcare perspective in The Netherlands. The gender- and age-specific modelling framework linked epidemiological aspects of invasive pneumococcal disease (e.g. incidence, mortality, life years lost) to vaccination and hospital resource use. To derive 90% confidence limits for net costs per life year gained a stochastic analysis was performed.
Pneumococcal vaccination in the elderly with the 23-valent vaccine. Effectiveness of the vaccine in preventing invasive pneumococcal disease was derived from international studies.
Pneumococcal vaccination in the elderly was not found to be cost saving. At baseline, stochastic and univariate sensitivity analysis net costs per life year gained were estimated to be between 6000 and 16,000 euro (EUR) [EUR1 = 1.1 US dollars; cost level 1995]. A scenario analysis on alternative age-dependent vaccination strategies indicated even higher net costs per life year gained, up to EUR28,000 for vaccinating only those elderly aged 85 years and over.
Pneumococcal vaccination is associated with net costs per life year gained of EUR10,100 (at baseline assumptions). These costs are higher than those for influenza vaccination (EUR5500). Our pharmacoeconomic approach, which needs to be considered in conjunction with social, psychological and budgetary issues, is intended to contribute to rational decision-making in healthcare policy.
评估荷兰65岁及以上老年人接种肺炎球菌疫苗的成本效益（每获得一个生命年的净成本）。
从荷兰医疗保健的角度进行了药物经济学分析。特定性别和年龄的建模框架将侵袭性肺炎球菌疾病的流行病学方面（如发病率、死亡率、生命年损失）与疫苗接种及医院资源使用联系起来。为得出每获得一个生命年的净成本的90%置信区间，进行了随机分析。
对老年人使用23价疫苗进行肺炎球菌疫苗接种。该疫苗预防侵袭性肺炎球菌疾病的有效性来自国际研究。
未发现老年人接种肺炎球菌疫苗具有成本节约效益。在基线时，随机和单变量敏感性分析得出每获得一个生命年的净成本估计在6000至16000欧元之间（1995年成本水平；1欧元 = 1.1美元）。对替代年龄依赖性疫苗接种策略的情景分析表明，每获得一个生命年的净成本甚至更高，仅对85岁及以上老年人接种疫苗时，净成本高达28000欧元。
肺炎球菌疫苗接种每获得一个生命年的净成本为10100欧元（基于基线假设）。这些成本高于流感疫苗接种的成本（5500欧元）。我们的药物经济学方法，需结合社会、心理和预算问题加以考虑，旨在为医疗保健政策的合理决策提供参考。
