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西班牙普遍接种婴儿轮状病毒疫苗的预算影响及成本效益分析。

Budget impact and cost-utility analysis of universal infant rotavirus vaccination in Spain.

作者信息

Imaz Iñaki, Rubio Beltrán, Cornejo Ana M, González-Enríquez Jesús

机构信息

Spanish Health Technology Assessment Agency (AETS-Agencia de Evaluación de Tecnologías Sanitarias), Institute for Health "Carlos III", 5 Monforte de Lemos, Madrid 28029, Spain; REDISSEC (Red de Investigación en Servicios de Salud en Enfermedades Crónicas-Spanish Health Services Research on Cronic Patients Network), Spain.

Spanish Health Technology Assessment Agency (AETS-Agencia de Evaluación de Tecnologías Sanitarias), Institute for Health "Carlos III", 5 Monforte de Lemos, Madrid 28029, Spain.

出版信息

Prev Med. 2014 Apr;61:116-21. doi: 10.1016/j.ypmed.2013.12.013. Epub 2013 Dec 18.

Abstract

Rotavirus is not included in the Spanish mass infant vaccination schedule but has also not been economically evaluated for its inclusion. We analysed cost-utility of the universal infant rotavirus vaccination using RotaTeq® versus no vaccination in Spain. We also carried out a budget impact analysis and determined the effect on results of different variables introduced in the model. A deterministic Markov model was built considering loss of quality of life for children and their parents, and introducing direct and indirect costs updated to 2011. The introduction of the vaccination using RotaTeq® as a universal infant vaccination would increase the annual health care budget in 10.43 million euro and would result in a gain of an additional Quality Adjusted Life Year at a cost of 280,338€ from the healthcare system perspective and 210,167€ from the societal perspective. The model was stable to variable modifications. To sum up, according to our model and estimates, the introduction of a universal infant rotavirus vaccination with RotaTeq® in Spain would cause a large impact on the health care budget and would not be efficient unless significant variations in vaccine price, vaccine efficacy and/or utilities took place.

摘要

轮状病毒疫苗未被纳入西班牙大规模婴儿疫苗接种计划,而且也未对其纳入计划进行经济学评估。我们分析了在西班牙使用罗特威疫苗(RotaTeq®)进行普遍婴儿轮状病毒疫苗接种与不接种疫苗的成本效益。我们还进行了预算影响分析,并确定了模型中引入的不同变量对结果的影响。构建了一个确定性马尔可夫模型,该模型考虑了儿童及其父母生活质量的损失,并引入了更新至2011年的直接和间接成本。从医疗保健系统角度来看,将罗特威疫苗(RotaTeq®)作为普遍婴儿疫苗接种引入,将使年度医疗保健预算增加1043万欧元,并将导致额外获得一个质量调整生命年,成本为280,338欧元;从社会角度来看,成本为210,167欧元。该模型对变量修改具有稳定性。总之,根据我们的模型和估计,在西班牙引入使用罗特威疫苗(RotaTeq®)的普遍婴儿轮状病毒疫苗接种将对医疗保健预算产生重大影响,除非疫苗价格、疫苗效力和/或效用发生重大变化,否则该接种计划将不具有成本效益。

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