Kotirum Surachai, Vutipongsatorn Naaon, Kongpakwattana Khachen, Hutubessy Raymond, Chaiyakunapruk Nathorn
School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; Social and Administrative Pharmacy Department, Faculty of Pharmacy, Rangsit University, Muang, Pathumthani, Thailand.
School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand.
Vaccine. 2017 Jun 8;35(26):3364-3386. doi: 10.1016/j.vaccine.2017.04.051. Epub 2017 May 11.
World Health Organization (WHO) recommends Rotavirus vaccines to prevent and control rotavirus infections. Economic evaluations (EE) have been considered to support decision making of national policy. Summarizing global experience of the economic value of rotavirus vaccines is crucial in order to encourage global WHO recommendations for vaccine uptake. Therefore, a systematic review of economic evaluations of rotavirus vaccine was conducted.
We searched Medline, Embase, NHS EED, EconLit, CEA Registry, SciELO, LILACS, CABI-Global Health Database, Popline, World Bank - e-Library, and WHOLIS. Full economic evaluations studies, published from inception to November 2015, evaluating Rotavirus vaccines preventing Rotavirus infections were included. The methods, assumptions, results and conclusions of the included studies were extracted and appraised using WHO guide for standardization of EE of immunization programs.
104 relevant studies were included. The majority of studies were conducted in high-income countries. Cost-utility analysis was mostly reported in many studies using incremental cost-effectiveness ratio per DALY averted or QALY gained. Incremental cost per QALY gained was used in many studies from high-income countries. Mass routine vaccination against rotavirus provided the ICERs ranging from cost-saving to highly cost-effective in comparison to no vaccination among low-income countries. Among middle-income countries, vaccination offered the ICERs ranging from cost-saving to cost-effective. Due to low- or no subsidized price of rotavirus vaccines from external funders, being not cost-effective was reported in some high-income settings.
Mass vaccination against rotavirus was generally found to be cost-effective, particularly in low- and middle-income settings according to the external subsidization of vaccine price. On the other hand, it may not be a cost-effective intervention at market price in some high-income settings. This systematic review provides supporting information to health policy-makers and health professionals when considering rotavirus vaccination as a national program.
世界卫生组织（WHO）推荐使用轮状病毒疫苗来预防和控制轮状病毒感染。经济评估（EE）已被视为支持国家政策决策的依据。总结轮状病毒疫苗经济价值的全球经验对于鼓励全球范围内遵循WHO的疫苗接种建议至关重要。因此，我们对轮状病毒疫苗的经济评估进行了系统综述。
我们检索了Medline、Embase、NHS EED、EconLit、CEA Registry、SciELO、LILACS、CABI - 全球健康数据库、Popline、世界银行电子图书馆和WHOLIS。纳入了从创刊至2015年11月发表的、评估轮状病毒疫苗预防轮状病毒感染的全面经济评估研究。使用WHO免疫规划经济评估标准化指南提取并评估纳入研究的方法、假设、结果和结论。
纳入了104项相关研究。大多数研究在高收入国家进行。许多研究大多采用每避免一个伤残调整生命年（DALY）或获得一个质量调整生命年（QALY）的增量成本效益比进行成本效用分析。高收入国家的许多研究使用了每获得一个QALY的增量成本。与低收入国家不接种疫苗相比，大规模常规接种轮状病毒疫苗的增量成本效益比（ICER）范围从节省成本到具有高度成本效益。在中等收入国家，接种疫苗的ICER范围从节省成本到具有成本效益。由于外部资助者提供的轮状病毒疫苗价格低或无补贴，一些高收入地区报告称接种疫苗不具有成本效益。
根据疫苗价格的外部补贴情况，普遍发现大规模接种轮状病毒疫苗具有成本效益，特别是在低收入和中等收入地区。另一方面，在某些高收入地区，按市场价格计算，这可能不是一项具有成本效益的干预措施。本系统综述为卫生政策制定者和卫生专业人员在考虑将轮状病毒疫苗接种作为国家计划时提供了支持信息。
