Sun S L, Gao Y Q, Yin J, Zhuang G H
Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Feb;37(2):238-42. doi: 10.3760/cma.j.issn.0254-6450.2016.02.018.
To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy, in China.
Through constructing decision tree-Markov model, we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as: group with no vaccination, Rotavirus vaccination group and Rotateq vaccination group, respectively. We determined the optimal program, based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).
Compared with non-vaccination group, the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss, respectively. RESULTS from sensitivity analysis indicated that both results were robust. Compared with Rotavirus vaccination program, the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss. Data from the sensitivity analysis indicated that the result was not robust.
From the perspective of health economics, both two-dose Rotarix vaccine and three-dose' s Rotateq vaccine programs were highly cost-effective, when compared to the non-vaccination program. It was appropriate to integrate rotavirus vaccine into the routine immunization program. Considering the large amount of extra cost that had to spend on Rotateq vaccination program, results from the sensitivity analysis showed that it was not robust. Rotateq vaccine required one more dose than the Rotarix vaccine, to be effective. However, it appeared more difficult to practice, suggesting that it was better to choose the Rotarix vaccine, at current stage.
评估中国目前通用的婴儿轮状病毒疫苗接种策略的成本效益。
通过构建决策树-马尔可夫模型，我们模拟了2012年不同疫苗接种方案下新生儿轮状病毒腹泻相关成本和健康结局，分别为：未接种组、Rotarix疫苗接种组和Rotateq疫苗接种组。基于增量成本效益比（ICER）与中国2012年人均国内生产总值（GDP）的比较，我们确定了最优方案。
与未接种组相比，Rotarix疫苗接种组和Rotateq疫苗接种组分别需支付3760元和7578元（均低于2012年人均GDP）以避免一个伤残调整生命年（DALY）损失。敏感性分析结果表明这两个结果均具有稳健性。与Rotarix疫苗接种方案相比，Rotateq疫苗接种方案需额外支付81068元（介于1至3倍人均GDP之间）以避免一个DALY损失。敏感性分析数据表明该结果不具有稳健性。
从卫生经济学角度来看，与未接种方案相比，两剂次的Rotarix疫苗和三剂次的Rotateq疫苗方案均具有很高的成本效益。将轮状病毒疫苗纳入常规免疫规划是合适的。考虑到Rotateq疫苗接种方案需花费大量额外成本，敏感性分析结果表明其不具有稳健性。Rotateq疫苗比Rotarix疫苗多一剂次才能有效。然而，其实施起来似乎更困难，这表明现阶段最好选择Rotarix疫苗。
