Luyten Jeroen, Beutels Philippe
Jeroen Luyten (
Philippe Beutels is a professor at the Centre for Health Economics Research and Modeling Infectious Diseases at the University of Antwerp, in Belgium.
Health Aff (Millwood). 2016 Feb;35(2):212-8. doi: 10.1377/hlthaff.2015.1088.
In the current global environment of increased strain on health care budgets, all medical interventions have to compete for funding. Cost-effectiveness analysis has become a standard method to use in estimating how much value an intervention offers relative to its costs, and it has become an influential element in decision making. However, the application of cost-effectiveness analysis to vaccination programs fails to capture the full contribution such a program offers to the community. Recent literature has highlighted how cost-effectiveness analysis can neglect the broader economic impact of vaccines. In this article we also argue that socioethical contributions such as effects on health equity, sustaining the public good of herd immunity, and social integration of minority groups are neglected in cost-effectiveness analysis. Evaluations of vaccination programs require broad and multidimensional perspectives that can account for their social, ethical, and economic impact as well as their cost-effectiveness.
在当前全球医疗保健预算压力增大的环境下，所有医疗干预措施都必须竞争资金。成本效益分析已成为一种标准方法，用于估计一项干预措施相对于其成本所提供的价值，并且它已成为决策中的一个有影响力的因素。然而，将成本效益分析应用于疫苗接种计划未能充分体现该计划对社区的全部贡献。最近的文献强调了成本效益分析如何可能忽略疫苗更广泛的经济影响。在本文中，我们还认为，诸如对健康公平性的影响、维持群体免疫的公共利益以及少数群体的社会融合等社会伦理贡献在成本效益分析中被忽视了。对疫苗接种计划的评估需要广泛和多维度的视角，以考虑其社会、伦理和经济影响以及成本效益。
