Navas E, Salleras L, Domínguez A, Ibáñez D, Prat A, Sentís J, Garrido P
Department of Health, Autonomous Government of Catalonia (Spain), Travessera de les Corts, 131-59, 08028 Barcelona, Spain.
Vaccine. 2007 Apr 20;25(16):3233-9. doi: 10.1016/j.vaccine.2007.01.038. Epub 2007 Jan 25.
The costs and benefits of vaccinating a theoretical cohort of 1000 preschool and school age children (3-14 years) with one dose of inactivated virosomal subunit influenza vaccine in primary health care centers of the Catalan Health Service during the fall annual health examination were compared with the current strategy of no routine vaccination. The economic analysis was carried out from the provider perspective (cost-effectiveness analysis) and from the societal perspective (cost-effectiveness and cost-benefit analysis). The time horizon of the study was established at 6 months. In the base case (cost of vaccination of euro 9.425, cost of paediatric visit plus antibiotic and antipyretic treatment of euro 42.50, cost of 1 day of hospital stay of euro 454.25, cost of the work lost by the mother to take care of her ill child of euro 29.2 and cost of 1 year of quality adjusted life year lost of euro 10,662), the vaccination does not save money from the provider perspective (net present value=euro-1460.51), but the cost-effectiveness ratios are very reasonable (euro 5.80 per episode of acute febrile respiratory process avoided and euro 18.26 per quality adjusted life year saved). From the societal perspective, the vaccination saves money (net present value=euro+7587.03) and the benefit-cost ratio is 1.80, meaning that euro 0.80 is saved per euro invested. Our study shows that vaccination of children 3-14 years old with a single dose of inactivated subunit influenza vaccine in primary health care centers during the fall annual health examination provides socioeconomic benefits to the society in addition to substantial health benefits for the child.
在加泰罗尼亚卫生服务中心的初级医疗保健机构,于秋季年度健康检查期间,给1000名理论上的学龄前和学龄儿童(3至14岁)接种一剂灭活病毒体亚单位流感疫苗的成本和效益,与当前不进行常规疫苗接种的策略进行了比较。经济分析从提供者角度(成本效益分析)和社会角度(成本效益和成本效益分析)进行。研究的时间范围设定为6个月。在基础案例中(疫苗接种成本为9.425欧元,儿科就诊加抗生素和解热治疗成本为42.50欧元,1天住院成本为454.25欧元,母亲照顾生病孩子所损失的工作成本为29.2欧元,1年质量调整生命年损失成本为10,662欧元),从提供者角度来看,疫苗接种并不能省钱(净现值=-1460.51欧元),但成本效益比非常合理(每避免一次急性发热呼吸道疾病发作成本为5.80欧元,每挽救一个质量调整生命年成本为18.26欧元)。从社会角度来看,疫苗接种能省钱(净现值=+7587.03欧元),效益成本比为1.80,这意味着每投资1欧元可节省0.80欧元。我们的研究表明,在秋季年度健康检查期间,在初级医疗保健机构给3至14岁儿童接种一剂灭活亚单位流感疫苗,除了给儿童带来巨大健康益处外,还为社会带来了社会经济效益。