Rheingans Richard D, Constenla Dagna, Antil Lynn, Innis Bruce L, Breuer Thomas
Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
Rev Panam Salud Publica. 2007 Apr;21(4):205-16. doi: 10.1590/s1020-49892007000300003.
To estimate the costs, benefits and cost-effectiveness of vaccination for rotavirus gastroenteritis in eight Latin American and Caribbean countries: Argentina, Brazil, Chile, the Dominican Republic, Honduras, Mexico, Panama, and Venezuela.
An economic model was constructed to estimate the cost-effectiveness of vaccination from the health care system perspective, using national administrative and published epidemiological evidence, country-specific cost estimates, and vaccine efficacy data. The model was applied to the first five years of life for the 2003 birth cohort in each country. The main health outcome was the disability-adjusted life year (DALY), and the main summary measure was the incremental cost per DALY averted. A 3% discount rate was used for all predicted costs and benefits. Sensitivity analyses evaluated the impact of uncertainty regarding key variables on cost-effectiveness estimates.
According to the estimates obtained with the economic model, vaccination would prevent more than 65% of the medical visits, deaths, and treatment costs associated with rotavirus gastroenteritis in the eight countries analyzed here. At a cost of US$ 24 per course (for a two-dose vaccine), the incremental cost-effectiveness ratio ranged from 269 US dollars/DALY in Honduras to 10,656 US dollars/DALY in Chile. Cost-effectiveness ratios were sensitive to assumptions about vaccine price, mortality, and vaccine efficacy.
Vaccination would effectively reduce the disease burden and health care costs of rotavirus gastroenteritis in the Latin American and Caribbean countries analyzed here. From the health care system perspective, universal vaccination of infants is predicted to be cost-effective, based on current standards.
评估在八个拉丁美洲和加勒比国家（阿根廷、巴西、智利、多米尼加共和国、洪都拉斯、墨西哥、巴拿马和委内瑞拉）接种轮状病毒肠胃炎疫苗的成本、效益和成本效益。
构建一个经济模型，从医疗保健系统的角度评估疫苗接种的成本效益，使用国家行政和已发表的流行病学证据、特定国家的成本估算以及疫苗效力数据。该模型应用于每个国家2003年出生队列的前五年。主要健康结果是伤残调整生命年（DALY），主要汇总指标是每避免一个DALY的增量成本。所有预测成本和效益均采用3%的贴现率。敏感性分析评估关键变量的不确定性对成本效益估计的影响。
根据经济模型得出的估计结果，接种疫苗将预防此处分析的八个国家中超过65%与轮状病毒肠胃炎相关的就诊、死亡和治疗成本。每疗程成本为24美元（针对两剂疫苗），增量成本效益比从洪都拉斯的269美元/DALY到智利的10656美元/DALY不等。成本效益比对标价、死亡率和疫苗效力的假设敏感。
接种疫苗将有效减轻此处分析的拉丁美洲和加勒比国家轮状病毒肠胃炎的疾病负担和医疗保健成本。从医疗保健系统的角度来看，根据当前标准，预计对婴儿进行普遍接种具有成本效益。
