Cheng Xiaoqing, Zhao Yueyuan, Zhang Xuefeng, Jin Hui, Min Jie
a Department of Epidemiology and Health Statistics , School of Public Health, Southeast University , Nanjing , China.
b Key Laboratory of Environmental Medicine Engineering , Ministry of Education, School of Public Health, Southeast University , Nanjing , China.
Hum Vaccin Immunother. 2017 Aug 3;13(8):1873-1878. doi: 10.1080/21645515.2017.1316913. Epub 2017 Apr 27.
Objective This study was conducted to assess the cost-effectiveness of hepatitis E vaccination of elderly population in the sporadic regions in China. Methods We used a decision tree-Markov model to evaluate the cost-effectiveness of 3 kinds of hepatitis E virus vaccination strategies from societal perspectives. Parameter estimates were obtained from published researches and experts' opinion. The time horizon was 16 years, and the discounted rate was 3% annually. Costs are expressed in 2016 US dollars. Results The universal vaccination strategy had an incremental cost-effectiveness ratio (ICER) of US$ 8475.90 per QALY gained versus no vaccination. The implementation of screening and vaccination strategy would have an ICER of US$ 4044.28, compared with no vaccination. The vaccination was cost-effective (ICER< 3 times China's per capital gross domestic product/quality-adjusted life years). The QALY of asymptomatic infection, vaccine coverage and vaccine protection are the important parameters impacting the ICER in one-way sensitivity analysis and screening and vaccination being the dominant strategy in probabilistic sensitivity analysis. Conclusion This analysis indicates that screening and vaccination is the most cost-effective hepatitis E intervention strategy of elderly population in sporadic region in China.
目的 本研究旨在评估中国散发病区老年人群戊型肝炎疫苗接种的成本效益。方法 我们采用决策树-马尔可夫模型从社会角度评估3种戊型肝炎病毒疫苗接种策略的成本效益。参数估计值来自已发表的研究和专家意见。时间跨度为16年，年贴现率为3%。成本以2016年美元表示。结果 与未接种疫苗相比，普遍接种策略每获得一个质量调整生命年（QALY）的增量成本效益比（ICER）为8475.90美元。与未接种疫苗相比，实施筛查和接种策略的ICER为4044.28美元。接种疫苗具有成本效益（ICER<3倍中国人均国内生产总值/质量调整生命年）。在单向敏感性分析中，无症状感染的QALY、疫苗接种覆盖率和疫苗保护是影响ICER的重要参数，在概率敏感性分析中，筛查和接种是主导策略。结论 该分析表明，筛查和接种是中国散发病区老年人群最具成本效益 的戊型肝炎干预策略。
