Merito Monica, Giorgi Rossi Paolo, Mantovani Jessica, Curtale Filippo, Borgia Piero, Guasticchi Gabriella
Laboratory of Economics and Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà 33, 56127 Pisa, Italy.
Vaccine. 2007 Jan 5;25(3):458-65. doi: 10.1016/j.vaccine.2006.08.005. Epub 2006 Aug 18.
Pneumococcal vaccination among the elderly is currently recommended in several western countries. We estimated the cost-effectiveness of a hypothetical vaccination campaign of 65+ year olds in the Lazio region (Italy). Baseline net costs per event averted and life-year gained, at 2001 prices, were euro 34,681 (95%CI: euro 28,699 to euro 42,929) and euro 23,361, respectively (95%CI: euro 16,419 to euro 38,297). Lower bacteraemic pneumonia incidence and vaccine effectiveness increased the net cost per life-year gained (ICER) to euro 53,899 and euro 74,313, respectively; in the best-case scenario the ICER was euro 4249. The case definition of invasive pneumococcal disease and, consequently, vaccine effectiveness are major uncertainties in countries with low incidence of pneumonia.
目前，几个西方国家建议对老年人进行肺炎球菌疫苗接种。我们估算了意大利拉齐奥地区针对65岁及以上人群开展的一次假设性疫苗接种活动的成本效益。按2001年价格计算，每避免一例事件和每获得一个生命年的基线净成本分别为34,681欧元（95%置信区间：28,699欧元至42,929欧元）和23,361欧元（95%置信区间：16,419欧元至38,297欧元）。较低的菌血症性肺炎发病率和疫苗效力分别使每获得一个生命年的净成本（增量成本效果比）增至53,899欧元和74,313欧元；在最佳情况下，增量成本效果比为4249欧元。在肺炎发病率较低的国家，侵袭性肺炎球菌疾病的病例定义以及相应的疫苗效力是主要的不确定因素。
