Kotirum Surachai, Muangchana Charung, Techathawat Sirirat, Dilokthornsakul Piyameth, Wu David Bin-Chia, Chaiyakunapruk Nathorn
School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.
Faculty of Pharmacy, Social and Administrative Pharmacy Department, Rangsit University, Muang Pathum Thani, Thailand.
Front Public Health. 2017 Nov 20;5:289. doi: 10.3389/fpubh.2017.00289. eCollection 2017.
Current study aimed to estimate clinical and economic outcomes of providing the type b (Hib) vaccination as a national vaccine immunization program in Thailand. A decision tree combined with Markov model was developed to simulate relevant costs and health outcomes covering lifetime horizon in societal and health care payer perspectives. This analysis considered children aged under 5 years old whom preventive vaccine of Hib infection are indicated. Two combined Hib vaccination schedules were considered: three-dose series (3 + 0) and three-dose series plus a booster does (3 + 1) compared with no vaccination. Budget impact analysis was also performed under Thai government perspective. The outcomes were reported as Hib-infected cases averted and incremental cost-effectiveness ratios (ICERs) in 2014 Thai baht (THB) ($) per quality-adjusted life year (QALY) gained. In base-case scenario, the model estimates that 3,960 infected cases, 59 disability cases, and 97 deaths can be prevented by national Hib vaccination program. The ICER for 3 + 0 schedule was THB 1,099 ($34) per QALY gained under societal perspective. The model was sensitive to pneumonia incidence among aged under 5 years old and direct non-medical care cost per episode of Hib pneumonia. Hib vaccination is very cost-effective in the Thai context. The budget impact analysis showed that Thai government needed to invest an additional budget of 110 ($3.4) million to implement Hib vaccination program. Policy makers should consider our findings for adopting this vaccine into national immunization program.
当前研究旨在评估在泰国将b型流感嗜血杆菌（Hib）疫苗接种作为国家疫苗免疫计划的临床和经济结果。开发了一种结合马尔可夫模型的决策树，以从社会和医疗保健支付方的角度模拟覆盖终身的相关成本和健康结果。该分析考虑了5岁以下需要接种Hib感染预防性疫苗的儿童。考虑了两种联合Hib疫苗接种方案：三剂次系列（3+0）和三剂次系列加一剂加强针（3+1），并与未接种疫苗的情况进行比较。还从泰国政府的角度进行了预算影响分析。结果报告为避免的Hib感染病例数以及每获得一个质量调整生命年（QALY）的增量成本效益比（ICER），以2014年泰铢（THB）（$）为单位。在基础情景中，该模型估计，国家Hib疫苗接种计划可预防3960例感染病例、59例残疾病例和97例死亡。在社会角度下，3+0方案的ICER为每获得一个QALY 1099泰铢（$34）。该模型对5岁以下儿童的肺炎发病率以及Hib肺炎每发作一次的直接非医疗护理成本敏感。在泰国的背景下，Hib疫苗接种具有很高的成本效益。预算影响分析表明，泰国政府需要额外投资1.1亿美元（$340万）来实施Hib疫苗接种计划。政策制定者应考虑我们的研究结果，以便将这种疫苗纳入国家免疫计划。
