Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
Value Health. 2011 Dec;14(8):1019-27. doi: 10.1016/j.jval.2011.05.045. Epub 2011 Aug 4.
To analyze the cost-effectiveness of a meningococcal C vaccination program in Brazil.
A hypothetical cohort of 3,194,038 children born in Brazil in 2006 was followed for 10 years. A decision tree model was developed using the TreeAge Pro 2007 software program to compare universal infant vaccination with the current program. Epidemiological and cost estimates were based on data retrieved from National Health Information Systems and the literature. The analysis was conducted from the public health care system and societal perspectives. Costs are expressed in 2006 Brazilian reals (R$).
At 94% coverage, the program would avoid 1,218 cases, 210 deaths, and 14,473 life-years lost, a reduction of, respectively, 45%, 44%, and 44%, for the 10-year period. Vaccination costs of R$320.9 million would not be offset by R$4 to R$7.9 million decreases in disease treatment costs. A national vaccination program would cost R$21,620 per life-year saved from the perspective of the health-care system and R$21,896 per life-year saved from society's perspective. Results were most sensitive to case fatality rate, disease incidence, and vaccine cost.
A universal childhood vaccination program against meningococcal C proved to be a cost-effective strategy, supporting the recent decision of the Brazilian government. These results could contribute to defining the most favorable price of the vaccine and to monitoring its impact on the population.
分析巴西开展脑膜炎球菌 C 型疫苗接种项目的成本效益。
对 2006 年在巴西出生的 3194038 名儿童进行了为期 10 年的随访。使用 TreeAge Pro 2007 软件程序建立了一个决策树模型，以比较普遍婴儿接种疫苗和现行计划。使用从国家卫生信息系统和文献中检索到的数据进行了流行病学和成本估算。分析从公共卫生保健系统和社会角度进行。成本以 2006 年巴西雷亚尔（R$）表示。
在 94%的覆盖率下，该计划将避免 1218 例病例、210 例死亡和 14473 个生命年损失，在 10 年内分别减少 45%、44%和 44%。疫苗接种费用为 3.209 亿雷亚尔，但不会因疾病治疗费用减少 400 万至 7900 万雷亚尔而得到弥补。从卫生保健系统的角度来看，国家接种计划每节省 1 个生命年的成本为 21620 雷亚尔，从社会的角度来看，每节省 1 个生命年的成本为 21896 雷亚尔。结果对病死率、发病率和疫苗成本最为敏感。
普遍开展儿童脑膜炎球菌 C 型疫苗接种计划被证明是一种具有成本效益的策略，支持了巴西政府最近的决定。这些结果有助于确定疫苗的最佳价格，并监测其对人群的影响。
