Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA.
Obstet Gynecol. 2012 Feb;119(2 Pt 1):306-14. doi: 10.1097/AOG.0b013e318242af27.
To estimate the potential economic benefits associated with hospital-based postpartum influenza vaccination.
We constructed a decision analysis model to estimate the potential cost benefit of this strategy from both a societal perspective and a third-party perspective. We included a hypothetical cohort of 1.47 million U.S. postpartum women, assuming an influenza season beginning September 1 and ending April 30. Probabilities and costs were derived from published literature, Centers for Disease Control and Prevention data, and expert recommendations. We used one-way and two-way sensitivity analyses. All cost estimates were inflated to year 2010 U.S. dollars and discounted at a 3% annual discount rate.
From the societal perceptive, the expected costs per vaccinated and unvaccinated mother were $328.45 and $341.02 respectively, resulting in an expected net benefit of $12.57 per vaccinated mother. The overall savings in the cohort were predicted to range from $3.69 to $14.75 million, depending on the vaccination coverage rate. This strategy would be cost-beneficial, holding all other variables to the base case, if the annual maternal influenza attack rate is more than 2.8%, influenza vaccine efficacy is more than 47%, or if vaccine acquisition and administration cost per dose are less than $32.78. The strategy would not generate net savings from the third-party perspective. Sensitivity analyses were robust, but disease incidence and vaccine efficacy were important drivers.
Our model suggests that postpartum influenza vaccination is a cost-beneficial approach for prevention of maternal and infantile influenza from a societal perspective.
III.
评估与医院产后流感疫苗接种相关的潜在经济效益。
我们构建了一个决策分析模型，从社会和第三方角度估算这种策略的潜在成本效益。我们纳入了一个假设的 147 万美国产后妇女队列，假设流感季节从 9 月 1 日开始，到 4 月 30 日结束。概率和成本来源于已发表的文献、疾病控制和预防中心的数据以及专家建议。我们进行了单因素和双因素敏感性分析。所有成本估计均换算为 2010 年的美元，并以 3%的年贴现率贴现。
从社会角度来看，每个接种和未接种母亲的预期成本分别为 328.45 美元和 341.02 美元，因此每个接种母亲的预期净收益为 12.57 美元。根据疫苗接种覆盖率的不同，该队列的总体节省预计在 369 万至 1475 万美元之间。如果每年的产妇流感发病率高于 2.8%、流感疫苗的效力高于 47%，或者每剂疫苗的获取和管理成本低于 32.78 美元，那么这种策略在所有其他变量保持基础病例的情况下是具有成本效益的。从第三方角度来看，这种策略不会产生净储蓄。敏感性分析稳健，但疾病发生率和疫苗效力是重要的驱动因素。
我们的模型表明，从社会角度来看，产后流感疫苗接种是预防母婴流感的一种具有成本效益的方法。
III 级。
