Kieffer Alexia, Hoestlandt Celine, Gil-Rojas Yaneth, Broban Anaïs, Castañeda-Cardona Camilo, Rosselli Diego
Sanofi Global Market Access, Sanofi Pasteur, Lyon, France.
Global Value and Access, Sanofi Pasteur, Lyon, France.
Value Health Reg Issues. 2019 Dec;20:60-65. doi: 10.1016/j.vhri.2019.01.004. Epub 2019 Apr 8.
To evaluate the public health benefits and economic value of live-attenuated yellow fever (YF) 17D vaccine in Colombia.
A decision tree model was used to assess the theoretical impact of routine YF vaccination of 1-year-olds (no "catch-up") during the interepidemic period from 1980 to 2002, avoiding capturing the impact of YF vaccine introduction in 2003. The vaccine was assumed to be 99% effective, to provide lifetime protection, and to cover 85% of the target population. Costs per disability-adjusted life-year (DALY) averted were computed from payer and societal perspectives. Univariate sensitivity analyses were performed.
During the interepidemic period, routine YF vaccination would have averted 2223 nonfatal cases of YF and 65 deaths, leading to an overall reduction of 1365 DALYs. The net cost of this vaccination would have been $25 964 813 (payer's perspective) and $16 535 465 (societal perspective). Cost per DALY averted was $19 022 and $12 114 from payer and societal perspectives, respectively (all costs in 2015 US dollars). Vaccination was considered cost-effective from both perspectives (ie, between 1- and 3-fold the gross domestic product per capita, $7158) and remains so if price per dose was $2.75 or less and $4.66 from payer and societal perspectives, respectively. Underreporting had the largest impact on the results.
Routine toddler YF vaccination in Colombia would have been considered cost-effective in the prevaccination era. This study provides insights on the value of vaccination in an upper middle-income country.
评估减毒活黄热病（YF）17D疫苗在哥伦比亚的公共卫生效益和经济价值。
采用决策树模型评估1980年至2002年流行间期对1岁儿童进行常规黄热病疫苗接种（无“补种”）的理论影响，避免纳入2003年引入黄热病疫苗的影响。假设该疫苗有效性为99%，可提供终身保护，且能覆盖85%的目标人群。从支付方和社会角度计算每避免一个伤残调整生命年（DALY）的成本。进行单因素敏感性分析。
在流行间期，常规黄热病疫苗接种可避免2223例非致命性黄热病病例和65例死亡，使DALY总数总体减少1365个。从支付方角度看，此次疫苗接种的净成本为25964813美元，从社会角度看为16535465美元。从支付方和社会角度计算，每避免一个DALY的成本分别为19022美元和12114美元（所有成本均以2015年美元计）。从两个角度看，疫苗接种均被认为具有成本效益（即为人均国内生产总值的1至3倍，7158美元），如果每剂疫苗价格分别为支付方角度2.75美元或更低以及社会角度4.
