Claes Christa, Graf von der Schulenburg Johann-Matthias
Institute for Insurance Economics, University of Hannover, Koenigsworther Platz 1, D-30167 Hannover, Germany.
Pharmacoeconomics. 2003;21(8):587-600. doi: 10.2165/00019053-200321080-00005.
The introduction of the conjugate vaccine PnC-7 implies that a pneumococcal vaccine is available, for the first time, which also gives children under the age of 2 years reliable protection against invasive pneumococcal infections and offers some protection against non-invasive pneumococcal infections. OBJECTIVE AND PERSPECTIVE: In the context of a multiple-period Markov model, a cost-effectiveness analysis of a recommendation for general pneumococcal vaccination in Germany for infants and children under the age of 2 years was performed from the healthcare payer, public authority and societal perspectives.
Various published data on age-specific incidence rates, mortality rates, efficacy of the conjugate vaccine PnC-7 and treatment costs of pneumococcal infections were incorporated into a Markov model to quantify the consequences of vaccinating versus not vaccinating.
From a German healthcare payers' perspective, general vaccination with the conjugate vaccine would redeem 51.1% of the vaccination costs due to avoidable treatment costs, whereas, from a broader point of view, the benefits, expressed in monetary terms, would exceed the cost of vaccination. The conjugate vaccine would require an investment of euro72 866 per life-year saved (discounted, healthcare payers' viewpoint). Besides this benchmark, there are further outcome measures which cannot be ignored by those deciding on a general vaccination recommendation: 450 000 preventable episodes of illness and 134 cases of sequelae which can be prevented.
The vaccination with the conjugate vaccine PnC-7 is cost saving from a broader perspective and the results should not be ignored by policy makers in regard to a general vaccination recommendation.
结合疫苗PnC - 7的引入意味着首次有了一种肺炎球菌疫苗,它能为2岁以下儿童提供针对侵袭性肺炎球菌感染的可靠保护,并对非侵袭性肺炎球菌感染提供一定保护。目标与前景:在多阶段马尔可夫模型的背景下,从医疗保健支付方、公共当局和社会角度,对德国针对2岁以下婴幼儿进行普遍肺炎球菌疫苗接种建议进行了成本效益分析。
将各种已发表的关于特定年龄发病率、死亡率、结合疫苗PnC - 7的疗效以及肺炎球菌感染治疗成本的数据纳入马尔可夫模型,以量化接种疫苗与不接种疫苗的后果。
从德国医疗保健支付方的角度来看,使用结合疫苗进行普遍接种将因可避免的治疗成本而挽回51.1%的疫苗接种成本,而从更广泛的角度来看,以货币形式表示的收益将超过疫苗接种成本。从医疗保健支付方的观点来看,按贴现计算,结合疫苗每挽救一个生命年需要投资72,866欧元。除了这个基准外,还有其他一些结果指标对于决定普遍接种建议的人来说不容忽视:可预防450,000次疾病发作以及134例后遗症。
从更广泛的角度来看,接种结合疫苗PnC - 7具有成本节约效益,政策制定者在考虑普遍接种建议时不应忽视这些结果。