Division of Vaccine-Preventable Disease Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.
Vaccine. 2013 May 31;31(24):2661-6. doi: 10.1016/j.vaccine.2013.04.014. Epub 2013 Apr 17.
In this study, we modeled the cost benefit analysis for three different measles vaccination strategies based upon three different measles-containing vaccines in Korea, 2001. We employed an economic analysis model using vaccination coverage data and population-based measles surveillance data, along with available estimates of the costs for the different strategies. In addition, we have included analysis on benefit of reduction of complication by mumps and rubella.
We evaluated four different strategies: strategy 1, keep-up program with a second dose measles-mumps-rubella (MMR) vaccine at 4-6 years without catch-up campaign; strategy 2, additional catch-up campaign with measles (M) vaccine; strategy 3, catch-up campaign with measles-rubella (MR) vaccine; and strategy 4, catch-up campaign with MMR vaccine. The cost of vaccination included cost for vaccines, vaccination practices and other administrative expenses. The direct benefit of estimated using data from National Health Insurance Company, a government-operated system that reimburses all medical costs spent on designated illness in Korea.
With the routine one-dose MMR vaccination program, we estimated a baseline of 178,560 measles cases over the 20 years; when the catch-up campaign with M, MR or MMR vaccines was conducted, we estimated the measles cases would decrease to 5936 cases. Among all strategies, the two-dose MMR keep-up program with MR catch-up campaign showed the highest benefit-cost ratio of 1.27 with a net benefit of 51.6 billion KRW.
Across different vaccination strategies, our finding suggest that MR catch-up campaign in conjunction with two-dose MMR keep-up program was the most appropriate option in terms of economic costs and public health effects associated with measles elimination strategy in Korea.
本研究旨在对韩国 2001 年三种含麻疹成分疫苗的三种不同麻疹疫苗接种策略的成本效益进行建模分析。我们采用经济分析模型,利用疫苗接种覆盖率数据和基于人群的麻疹监测数据,以及不同策略的可用成本估算。此外,我们还分析了减少腮腺炎和风疹并发症的效益。
我们评估了四种不同的策略:策略 1,在 4-6 岁时保持接种第二剂麻疹-腮腺炎-风疹(MMR)疫苗的计划,不进行补种运动;策略 2,在 M 疫苗的基础上增加补种运动;策略 3,在 MR 疫苗的基础上进行补种运动;策略 4,在 MMR 疫苗的基础上进行补种运动。疫苗接种成本包括疫苗、接种实践和其他行政费用。使用韩国政府运营的国民健康保险公司的数据来估计直接效益,该系统报销韩国指定疾病的所有医疗费用。
采用常规一剂 MMR 疫苗接种计划,我们估计在 20 年内将有 178560 例麻疹病例;当进行 M、MR 或 MMR 疫苗补种运动时,我们估计麻疹病例将减少到 5936 例。在所有策略中,两剂 MMR 维持计划与 MR 补种运动的效益成本比最高,为 1.27,净效益为 5160 亿韩元。
在不同的疫苗接种策略中,我们的发现表明,MR 补种运动与两剂 MMR 维持计划相结合是韩国消除麻疹策略在经济成本和公共卫生效果方面最适当的选择。