Wu Gui-Ying, Gong You-Long, Yu Shu-Li, Shao Rui-Tai, Qin Huai-Jin
Department of Health Statistics of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Jun;25(6):474-8.
To study the cost-effectiveness, benefit and utility of infant hepatitis B vaccination in Shanghai from 1992 to 2001.
To calculate the cost of hepatitis B vaccination by cost analysis method. Both the numbers of persons with HBsAg positive and patient with hepatitis B, cirrhosis and liver cancer decreased as the index of direct effect. To study the sick-time and the cost of treating hepatitis B, cirrhosis and liver cancer patients, a face to face questionnaire was used and quasi method was adopted to understand the effect of cure and the course of hepatitis B. The cost benefit analysis method was also used to calculate the cost benefit of HBV vaccine. The disability adjusted life years (DALY) was regarded as an index of utility to measure the disease burden.
Input of 501,129.49 Yuan might have the result of reducing one liver cancer patient, ten cirrhosis patients, one hundred chronic hepatitis B patients and one thousand HBsAg positive people. The cost of hepatitis B vaccination was 0.24 hundred million Yuan during the past ten years in Shanghai, which had obtained the total benefit value of 41.22 hundred million Yuan, with a cost benefit ratio of 1:172 Yuan. It was estimated that the total disease burden of hepatitis B, cirrhosis and liver cancer patients was 59,762.55 DALY in order to reduce one DALY loss cost of 402.50 Yuan.
HBV vaccine inoculation in infants seemed to be a low-cost input and high-effect output strategy.
研究1992年至2001年上海市婴儿乙肝疫苗接种的成本效益、效益及效用。
采用成本分析法计算乙肝疫苗接种成本。以HBsAg阳性人数以及乙肝、肝硬化和肝癌患者人数的减少作为直接效果指标。通过面对面问卷调查并采用准方法了解乙肝患者的患病时间及治疗成本,以及乙肝的治愈效果和病程。还运用成本效益分析法计算乙肝疫苗的成本效益。将伤残调整生命年(DALY)作为衡量疾病负担的效用指标。
投入501,129.49元可能会使肝癌患者减少1例、肝硬化患者减少10例、慢性乙肝患者减少100例以及HBsAg阳性者减少1000例。过去十年上海乙肝疫苗接种成本为2400万元,获得的总效益值为41.22亿元,成本效益比为1:172元。估计乙肝、肝硬化和肝癌患者的总疾病负担为59,762.55 DALY,为减少1个DALY损失成本为402.50元。
婴儿接种乙肝疫苗似乎是一种低成本投入、高效益产出的策略。