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爱尔兰儿童普遍接种肺炎球菌结合疫苗策略的经济学评估。

Economic evaluation of a universal childhood pneumococcal conjugate vaccination strategy in Ireland.

作者信息

Tilson Lesley, Usher Cara, Butler Karina, Fitzsimons John, O'Hare Fiona, Cotter Suzanne, O'Flanagan Darina, Johnson Howard, Barry Michael

机构信息

National Centre for Pharmacoeconomics, St. James's Hospital, Dublin, Ireland.

出版信息

Value Health. 2008 Sep-Oct;11(5):898-903. doi: 10.1111/j.1524-4733.2008.00341.x. Epub 2008 May 16.

Abstract

OBJECTIVE

To evaluate the cost-effectiveness of implementing a universal infant 7-valent pneumococcal conjugate vaccine (PCV7) vaccination program in the Irish health-care setting from the health-care payers' perspective.

METHODS

A model was constructed in MS Excel to follow a cohort of vaccinated and unvaccinated individuals from birth over a 5-year period. The reduction in events that would be associated with PCV7 vaccination and the mortality and cost resulting from these events were analyzed. In a separate submodel, the effect of herd immunity was investigated.

RESULTS

Implementing a PCV7 vaccine program in Ireland in a birth cohort of 61,000 infants would be expected to prevent 7703 cases of pneumococcal-related infections over 5 years, resulting in costs avoided of 2.05 million euros increasing to 4.6 million euros if the effect of herd immunity was included. The baseline incremental cost-effectiveness ratio was 249,591 euros/life years gained (LYG), which reduced to 5997 euros/LYG when the effect of herd immunity was included.

CONCLUSIONS

A universal infant pneumococcal conjugate vaccination could be considered highly cost-effective in the Irish health-care setting from a health-care payers' perspective, if viewed in terms of the herd immunity effect. The results of this study have positive ramifications for countries in the early stages of health technology assessment.

摘要

目的

从医疗保健支付方的角度评估在爱尔兰医疗保健环境中实施通用婴儿7价肺炎球菌结合疫苗(PCV7)接种计划的成本效益。

方法

在MS Excel中构建一个模型,跟踪一组从出生起5年内接种和未接种疫苗的个体。分析与PCV7接种相关的事件减少情况以及这些事件导致的死亡率和成本。在一个单独的子模型中,研究群体免疫的效果作用。

结果

在爱尔兰为61000名婴儿的出生队列实施PCV7疫苗计划,预计5年内可预防7703例肺炎球菌相关感染,避免的成本为205万欧元,如果包括群体免疫的效果作用,成本将增加到460万欧元。基线增量成本效益比为249591欧元/获得的生命年(LYG),纳入群体免疫效果作用后降至5997欧元/LYG。

结论

从医疗保健支付方的角度来看,如果考虑群体免疫效果作用,在爱尔兰医疗保健环境中,通用婴儿肺炎球菌结合疫苗接种可被认为具有很高的成本效益。本研究结果对处于卫生技术评估早期阶段的国家具有积极影响。

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