Turner D A, Wailoo A J, Cooper N J, Sutton A J, Abrams K R, Nicholson K G
Department of Health Sciences, University of Leicester, UK.
Vaccine. 2006 Feb 13;24(7):1035-43. doi: 10.1016/j.vaccine.2004.12.033. Epub 2005 Sep 6.
Influenza can cause significant morbidity and mortality. Influenza vaccination is an effective and safe strategy in the prevention of influenza. Currently the National Health Service (NHS) vaccinates 'at-risk' individuals only. This definition includes everyone over 65 years of age but excludes individuals 50-64 years of age unless they have an additional risk factor, such as underlying heart disease or lung disease. In order to examine the cost-effectiveness of an extension of the vaccination policy to include this age group we constructed an economic model to estimate the costs and benefits of vaccination from both a health service and a societal perspective. Data to populate the model was obtained from the literature and the outcome measure used was the quality adjusted life year (QALY). Influenza vaccination prevented an estimated 4508 cases (95% CI: 2431-7606) per 100,000 vaccinees per influenza season for a net cost to the NHS of pound653,221 (95% CI: 354,575-1,072,257). The net cost increased to pound1,139,069 (95% CI 27,052-2,030,473) when non-NHS costs were included and the estimated cost-per-QALY were pound6174 and pound10,766 for NHS and all costs respectively. Extension of the current immunisation policy has the potential to generate a significant health benefit at a comparatively low cost.
流感可导致严重的发病和死亡。流感疫苗接种是预防流感的一种有效且安全的策略。目前，英国国家医疗服务体系（NHS）仅为“高危”人群接种疫苗。这一定义包括所有65岁以上的人，但不包括50 - 64岁的人，除非他们有其他风险因素，如潜在的心脏病或肺病。为了研究将疫苗接种政策扩大到该年龄组的成本效益，我们构建了一个经济模型，从医疗服务和社会角度估计疫苗接种的成本和效益。用于填充模型的数据来自文献，所使用的结果指标是质量调整生命年（QALY）。每个流感季节，每10万名接种疫苗者中，流感疫苗估计可预防4508例病例（95%置信区间：2431 - 7606），NHS的净成本为653,221英镑（95%置信区间：354,575 - 1,072,257）。纳入非NHS成本后，净成本增至1,139,069英镑（95%置信区间27,052 - 2,030,473），NHS成本和所有成本的估计每QALY成本分别为6174英镑和10,766英镑。扩大当前的免疫政策有可能以相对较低的成本产生显著的健康效益。
