Hu Shanlian, Shi Qiang, Song Shengfan, Du Lixia, He Jiangjiang, Chen Chieh-I, Caldwell Ronald, Wang Bruce, Roberts Craig S
School of Public Health, Fudan University, Shanghai, P.R. China; Shanghai Health Development Research Center, Shanghai, P.R. China.
Health Economics and Outcomes Research, Pfizer Investment Co. Ltd., Shanghai, P.R. China.
Value Health Reg Issues. 2014 May;3:197-204. doi: 10.1016/j.vhri.2014.04.007. Epub 2014 Jun 2.
The goal of this study was to analyze the economic benefits of introducing the 7-valent pneumococcal conjugate vaccine (PCV7) into the City Immunity Program in Shanghai.
A decision-analytic model designed for pneumococcal disease and outcomes of pneumococcal infection was populated with local, age-specific incidence and cost data to estimate the expected economic benefits from vaccinating a birth cohort of 172,183 infants in Shanghai over a 1-year period using a cross-sectional approach. The analysis was assumed to occur in a year at which time the direct and indirect effects of vaccination have reached a steady state. Costs were calculated from a payer perspective and included vaccination program costs and direct medical expenditures from pneumococcal-related disease.
The model predicts that 112,629 cases of pneumococcal-related disease could be prevented during a given year following the introduction of the PCV7 vaccine into the City Immunity Program in Shanghai, leading to a reduction of ¥187,923,359 (US $29,067,790) in direct medical costs. Overall, the inclusion of the PCV7 vaccine is estimated to have a cost-per-life-year saved of ¥37,468 (US $5,796) and a cost-per-quality-adjusted-life-year gained of ¥41,603 (US $6,435) when both the direct and indirect effects of the vaccine resulting from herd protection are taken into account.
Results suggest that including PCV7 into the City Immunity Program in Shanghai could be considered cost-effective under generally accepted willingness-to-pay thresholds when both the direct and indirect effects of the vaccine are considered in the analysis.
本研究旨在分析将7价肺炎球菌结合疫苗（PCV7）引入上海市城市免疫规划的经济效益。
采用横断面方法，利用本地特定年龄发病率和成本数据，构建针对肺炎球菌疾病及肺炎球菌感染结局的决策分析模型，以估算对上海市172,183名婴儿出生队列进行为期1年的疫苗接种的预期经济效益。分析假设在疫苗接种的直接和间接影响达到稳态的某一年进行。成本从支付者角度计算，包括疫苗接种项目成本和肺炎球菌相关疾病的直接医疗支出。
该模型预测，在上海市城市免疫规划中引入PCV7疫苗后的特定年份，可预防112,629例肺炎球菌相关疾病，直接医疗成本降低187,923,359元（29,067,790美元）。总体而言，若同时考虑疫苗群体保护产生的直接和间接影响，纳入PCV7疫苗估计每挽救一个生命年的成本为37,468元（5,796美元），每获得一个质量调整生命年的成本为41,603元（6,435美元）。
结果表明，在分析中同时考虑疫苗的直接和间接影响时，根据普遍接受的支付意愿阈值，将PCV7纳入上海市城市免疫规划可被视为具有成本效益。
