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基于 CRM197 的 7 价肺炎球菌结合疫苗(PCV7)在阿根廷的成本效益分析。

Cost-effectiveness of the CRM-based 7-valent pneumococcal conjugated vaccine (PCV7) in Argentina.

机构信息

Hospital de Niños Ricardo Gutierrez Buenos Aires, Argentina.

出版信息

Vaccine. 2010 Mar 8;28(11):2302-10. doi: 10.1016/j.vaccine.2009.12.070. Epub 2010 Jan 9.

DOI:10.1016/j.vaccine.2009.12.070
PMID:20064478
Abstract

UNLABELLED

Due to the region's own conditions, universal vaccination with pneumococcal conjugate heptavalent vaccine (PCV-7) in Latin American countries is still controversial.

OBJECTIVE

To compare projected economic costs and health benefits associated with pneumococcal conjugate heptavalent vaccine as a routine immunization in healthy children in Argentina.

DESIGN

A decision analytic model of Markov simulated lifetime evolution of a birth cohort (n 696,451) was developed and compared costs and health benefits of pneumococcal disease in the presence and absence of vaccination.

MAIN OUTCOME MEASURES

Cost per life year (LY) gained, reduce in diseases burden and costs of vaccination.

RESULTS

From the society's perspective, the incremental cost per LY gained was US$ 5599.42 and the purchase of the 4 doses of vaccine for the entire cohort with a cost of US$ 26.5 dose requires an investment of US$ 73,823,806.00. The model estimated that vaccination reduce the number of death by 159 cases of meningitis, 756 cases of bacteriemias 4594 cases of pneumonias about 84,769 cases of otitis media and 20 meningitis sequelae. The value of the cost per LY gained was considerably modified by the variation in the cost of the vaccine dose, efficacy/effectiveness of the vaccine for pneumonia the mortality from pneumonia and herd immunity.

CONCLUSIONS

Our analysis predicted that routine vaccination of healthy infants <2 years could prevent an important number of pneumococcal infectious and reduce related mortality and morbidity. This strategic could be highly cost-effective in Argentina.

摘要

未加标签

由于该地区的自身条件,在拉丁美洲国家使用肺炎球菌结合型七价疫苗(PCV-7)进行普遍疫苗接种仍存在争议。

目的

比较在阿根廷,将肺炎球菌结合型七价疫苗作为常规免疫接种用于健康儿童的预期经济成本和健康效益。

设计

建立了针对出生队列(n=696451)的马尔可夫模拟终生演变的决策分析模型,并比较了存在和不存在疫苗接种情况下肺炎球菌疾病的成本和健康效益。

主要观察指标

每获得生命年(LY)的成本、疾病负担减少和疫苗接种成本。

结果

从社会角度来看,每获得 LY 的增量成本为 5599.42 美元,为整个队列购买 4 剂疫苗的费用为 26.5 美元/剂,需要投资 73823806.00 美元。该模型估计,接种疫苗可减少 159 例脑膜炎、756 例菌血症、4594 例肺炎、约 84769 例中耳炎和 20 例脑膜炎后遗症的死亡人数。每获得 LY 的成本值受到疫苗剂量成本、肺炎疫苗的疗效/效果、肺炎死亡率和群体免疫的变化的极大影响。

结论

我们的分析预测,对<2 岁的健康婴儿进行常规疫苗接种可以预防大量的肺炎球菌感染,并降低相关的死亡率和发病率。这一策略在阿根廷可能具有很高的成本效益。

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