Ghebrehewet Sam, Thorrington Dominic, Farmer Siobhan, Kearney James, Blissett Deidre, McLeod Hugh, Keenan Alex
Health Protection Team, Cheshire and Merseyside Public Health England Centre, Public Health England, L1 1JF Liverpool, UK.
Centre for the Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Vaccine. 2016 Apr 4;34(15):1823-31. doi: 10.1016/j.vaccine.2016.02.029. Epub 2016 Mar 2.
Measles is a highly contagious vaccine-preventable infection that caused large outbreaks in England in 2012 and 2013 in areas which failed to achieve herd protection levels (95%) consistently. We sought to quantify the economic costs associated with the 2012-13 Merseyside measles outbreak, relative to the cost of extending preventative vaccination to secure herd protection.
A costing model based on a critical literature review was developed. A workshop and interviews were held with key stakeholders in the Merseyside outbreak to understand the pathway of a measles case and then quantify healthcare activity and costs for the main NHS providers and public health team incurred during the initial four month period to May 2012. These data were used to model the total costs of the full outbreak to August 2013, comprising those to healthcare providers for patient treatment, public health and societal productivity losses. The modelled total cost of the full outbreak was compared to the cost of extending the preventative vaccination programme to achieve herd protection.
The Merseyside outbreak included 2458 reported cases. The estimated cost of the outbreak was £ 4.4m (sensitivity analysis £ 3.9 m to £ 5.2m) comprising 15% (£ 0.7 m) NHS patient treatment costs, 40% (£ 1.8m) public health costs and 44% (£ 2.0m) for societal productivity losses. In comparison, over the previous five years in Cheshire and Merseyside a further 11,793 MMR vaccinations would have been needed to achieve herd protection at an estimated cost of £ 182,909 (4% of the total cost of the measles outbreak).
Failure to consistently reach MMR uptake levels of 95% across all localities and sectors (achieve herd protection) risks comparatively higher economic costs associated with the containment (including healthcare costs) and implementation of effective public health management of outbreaks.
Commissioned by the Cheshire and Merseyside Public Health England Centre.
麻疹是一种极具传染性的可通过疫苗预防的感染性疾病，2012年和2013年在英格兰未能持续达到群体免疫保护水平（95%）的地区引发了大规模疫情。我们试图量化2012 - 13年默西塞德郡麻疹疫情的经济成本，并与扩大预防性疫苗接种以确保群体免疫保护的成本进行比较。
基于批判性文献综述开发了一个成本核算模型。与默西塞德郡疫情的主要利益相关者举行了一次研讨会并进行了访谈，以了解麻疹病例的发病过程，然后量化2012年5月前四个月期间主要国民保健服务提供者和公共卫生团队产生的医疗活动及成本。这些数据被用于模拟到2013年8月整个疫情的总成本，包括医疗服务提供者的患者治疗成本、公共卫生成本和社会生产力损失。将模拟的整个疫情总成本与扩大预防性疫苗接种计划以实现群体免疫保护的成本进行比较。
默西塞德郡疫情报告了2458例病例。疫情的估计成本为440万英镑（敏感性分析为390万英镑至520万英镑），其中15%（70万英镑）为国民保健服务患者治疗成本，40%（180万英镑）为公共卫生成本，44%（200万英镑）为社会生产力损失。相比之下，在柴郡和默西塞德郡过去五年中，要实现群体免疫保护还需要额外接种11793剂麻疹、腮腺炎和风疹联合疫苗，估计成本为182909英镑（占麻疹疫情总成本的4%）。
未能在所有地区和部门持续达到95%的麻疹、腮腺炎和风疹联合疫苗接种水平（实现群体免疫保护），有可能导致与疫情控制（包括医疗成本）及实施有效的疫情公共卫生管理相关的经济成本相对更高。
由柴郡和默西塞德郡英国公共卫生中心委托。
