Thompson Kimberly M, Odahowski Cassie L
Kid Risk, Inc, 10524 Moss Park Rd., Ste. 204-364, Orlando, FL, 32832, USA.
College of Medicine, University of Central Florida, Orlando, FL, 32827, USA.
Risk Anal. 2016 Jul;36(7):1297-314. doi: 10.1111/risa.12331. Epub 2014 Dec 24.
Economic analyses for vaccine-preventable diseases provide important insights about the value of prevention. We reviewed the literature to identify all of the peer-reviewed, published economic analyses of interventions related to measles and rubella immunization options to assess the different types of analyses performed and characterize key insights. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English and found 67 analyses that reported primary data and quantitative estimates of benefit-cost or cost-effectiveness analyses for measles and/or rubella immunization interventions. We removed studies that we characterized as cost-minimization analyses from this sample because they generally provide insights that focused on more optimal strategies to achieve the same health outcome. The 67 analyses we included demonstrate the large economic benefits associated with preventing measles and rubella infections using vaccines and the benefit of combining measles and rubella antigens into a formulation that saves the costs associated with injecting the vaccines separately. Despite the importance of population immunity and dynamic viral transmission, most of the analyses used static models to estimate cases prevented and characterize benefits, although the use of dynamic models continues to increase. Many of the analyses focused on characterizing the most significant adverse outcomes (e.g., mortality for measles, congenital rubella syndrome for rubella) and/or only direct costs, and the most complete analyses present data from high-income countries.
对疫苗可预防疾病的经济分析为预防的价值提供了重要见解。我们查阅了文献，以找出所有经同行评审并发表的关于麻疹和风疹免疫接种选项相关干预措施的经济分析，从而评估所进行的不同类型分析，并梳理关键见解。我们在PubMed、科学引文索引以及相关文章的参考文献中搜索英文研究，共找到67项分析，这些分析报告了麻疹和/或风疹免疫接种干预措施的原始数据以及效益成本或成本效益分析的定量估计。我们从该样本中剔除了我们归类为成本最小化分析的研究，因为它们通常提供的见解侧重于实现相同健康结果的更优策略。我们纳入的67项分析表明，使用疫苗预防麻疹和风疹感染具有巨大的经济效益，以及将麻疹和风疹抗原组合成一种制剂可节省分别注射疫苗相关成本的效益。尽管群体免疫和病毒动态传播很重要，但大多数分析使用静态模型来估计预防的病例数并描述效益，不过动态模型的使用在不断增加。许多分析侧重于描述最显著的不良后果（如麻疹的死亡率、风疹的先天性风疹综合征）和/或仅直接成本，而且最全面的分析呈现的是来自高收入国家的数据。
