使用简单经济模型对利比亚儿童轮状病毒疫苗接种进行成本效益分析。
Cost-effectiveness analysis of rotavirus vaccination among Libyan children using a simple economic model.
作者信息
Alkoshi Salem, Orhun Nimetcan Mehmet, Dahlui Maznah
机构信息
Julius Centre, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;
International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia.
出版信息
Libyan J Med. 2014 Dec 9;9(1):26236. doi: 10.3402/ljm.v9.26236. eCollection 2014.
BACKGROUND
Rotavirus infection is a major cause of childhood diarrhea in Libya. The objective of this study is to evaluate the cost-effectiveness of rotavirus vaccination in that country.
METHODS
We used a published decision tree model that has been adapted to the Libyan situation to analyze a birth cohort of 160,000 children. The evaluation of diarrhea events in three public hospitals helped to estimate the rotavirus burden. The economic analysis was done from two perspectives: health care provider and societal. Univariate sensitivity analyses were conducted to assess uncertainty in some values of the variables selected.
RESULTS
The three hospitals received 545 diarrhea patients aged≤5 with 311 (57%) rotavirus positive test results during a 9-month period. The societal cost for treatment of a case of rotavirus diarrhea was estimated at US$ 661/event. The incremental cost-effectiveness ratio with a vaccine price of US$ 27 per course was US$ 8,972 per quality-adjusted life year gained from the health care perspective. From a societal perspective, the analysis shows cost savings of around US$ 16 per child.
CONCLUSION
The model shows that rotavirus vaccination could be economically a very attractive intervention in Libya.
背景
轮状病毒感染是利比亚儿童腹泻的主要原因。本研究的目的是评估该国轮状病毒疫苗接种的成本效益。
方法
我们使用了一个已根据利比亚情况进行调整的已发表决策树模型，对160,000名儿童的出生队列进行分析。对三家公立医院腹泻事件的评估有助于估计轮状病毒负担。经济分析从两个角度进行：医疗服务提供者和社会。进行单因素敏感性分析以评估所选变量某些值的不确定性。
结果
在9个月期间，三家医院共接收了545名年龄≤5岁的腹泻患者，其中311例（57%）轮状病毒检测呈阳性。治疗一例轮状病毒腹泻的社会成本估计为每次事件661美元。从医疗保健角度来看，每疗程疫苗价格为27美元时，增量成本效益比为每获得一个质量调整生命年8972美元。从社会角度来看，分析表明每个儿童可节省约16美元。
结论
该模型表明，轮状病毒疫苗接种在利比亚可能在经济上是一种非常有吸引力的干预措施。
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