Salo Heini, Sintonen Harri, Nuorti J Pekka, Linna Miika, Nohynek Hanna, Verho Jouko, Kilpi Terhi
Department of Vaccines, National Public Health Institute (KTL), Helsinki, Finland.
Scand J Infect Dis. 2005;37(11-12):821-32. doi: 10.1080/00365540500321512.
The aim of this study was to evaluate cost-effectiveness of pneumococcal conjugate vaccine (PCV7) in children <5 y of age. A Markov simulation model was used to compare the cost-effectiveness of 4 doses (assumed 50.5 euros per dose) of PCV7 with no intervention. Only direct effects of the vaccine were taken into account. In Finland, vaccination of a birth cohort of 57,500 healthy infants would potentially prevent annually 60 cases of invasive PD, 1,400 cases of pneumococcal pneumonia, 15,000 episodes of acute otitis media, 3,000 otological surgery procedures and 0.9 deaths in children aged <5 y. Investing 12.0 million euros to vaccinate a birth cohort would save annually 6.3 million euros in medical, and 2.0 million euros in productivity and other, costs. Therefore, investing 1 euros in a vaccination programme would return 0.53 euros in medical costs and 0.70 euros in societal costs. In the base case, vaccination would cost society 139,986 euros per life y gained. To achieve cost savings from a health care provider (societal) perspective, without considering herd effects or replacement phenomenon, the price of PCV7 should be 50% (70%) of the price used in the base case.
本研究旨在评估肺炎球菌结合疫苗(PCV7)在5岁以下儿童中的成本效益。采用马尔可夫模拟模型比较4剂PCV7(假设每剂50.5欧元)与不进行干预的成本效益。仅考虑疫苗的直接效果。在芬兰,对57,500名健康婴儿的出生队列进行疫苗接种,每年可能预防60例侵袭性肺炎球菌病、1400例肺炎球菌肺炎、15,000例急性中耳炎、3000例耳科手术以及5岁以下儿童中的0.9例死亡。投资1200万欧元为一个出生队列接种疫苗,每年可节省630万欧元的医疗费用以及200万欧元的生产力和其他费用。因此,在疫苗接种计划中每投入1欧元,可在医疗费用方面回报0.53欧元,在社会成本方面回报0.70欧元。在基础案例中,每获得1年生命,疫苗接种将使社会花费139,986欧元。为了从医疗服务提供者(社会)的角度实现成本节约,在不考虑群体效应或替代现象的情况下,PCV7的价格应为基础案例中所使用价格的50%(70%)。