Thompson Kimberly M, Odahowski Cassie L
Kid Risk, Inc, Orlando, FL, USA.
University of Central Florida, College of Medicine, Orlando, FL, USA.
Risk Anal. 2016 Jul;36(7):1357-82. doi: 10.1111/risa.12459. Epub 2015 Aug 5.
National and global health policymakers require good information about the costs and benefits of their investments in measles and rubella immunization programs. Building on our review of the existing measles and rubella health economics literature, we develop inputs for use in regional and global models of the expected future benefits and costs of vaccination, treatment, surveillance, and other global coordination activities. Given diversity in the world and limited data, we characterize the costs for countries according to the 2013 World Bank income levels using 2013 U.S. dollars (2013$US). We estimate that routine immunization and supplemental immunization activities will cost governments and donors over 2013$US 2.3 billion per year for the foreseeable future, with high-income countries accounting for 55% of the costs, to vaccinate global birth cohorts of approximately 134 million surviving infants and to protect the global population of over 7 billion people. We find significantly higher costs and health consequences of measles or rubella disease than with vaccine use, with the expected disability-adjusted life year (DALY) loss for case of disease generally at least 100 times the loss per vaccine dose. To support estimates of the economic benefits of investments in measles and/or rubella elimination or control, we characterize the probabilities of various sequelae of measles and rubella infections and vaccine adverse events, the DALY inputs for health outcomes, and the associated treatment costs. Managing measles and rubella to achieve the existing and future regional measles and rubella goals and the objectives of the Global Vaccine Action Plan will require an ongoing commitment of financial resources that will prevent adverse health outcomes and save the associated treatment costs.
国家和全球卫生政策制定者需要有关其在麻疹和风疹免疫计划方面投资的成本和效益的良好信息。基于我们对现有麻疹和风疹卫生经济学文献的综述，我们开发了一些投入要素，用于区域和全球模型，以预测疫苗接种、治疗、监测及其他全球协调活动未来的效益和成本。鉴于世界情况的多样性和数据有限，我们根据2013年世界银行的收入水平，以2013年美元（2013$US）为单位描述各国的成本。我们估计，在可预见的未来，常规免疫和补充免疫活动每年将使政府和捐助者花费超过2013年美元23亿，其中高收入国家占成本的55%，为全球约1.34亿存活婴儿的出生队列接种疫苗，并保护全球超过70亿人口。我们发现，麻疹或风疹疾病的成本和健康后果明显高于疫苗使用，疾病病例的预期伤残调整生命年（DALY）损失通常至少是每剂疫苗损失的100倍。为了支持对消除或控制麻疹和/或风疹投资的经济效益估计，我们描述了麻疹和风疹感染及疫苗不良事件各种后遗症的概率、健康结果的DALY投入以及相关治疗成本。管理麻疹和风疹以实现现有及未来的区域麻疹和风疹目标以及《全球疫苗行动计划》的目标，将需要持续投入财政资源，这将预防不良健康后果并节省相关治疗成本。
