Schoenbaum S C
Am J Med. 1987 Jun 19;82(6A):26-30. doi: 10.1016/0002-9343(87)90557-2.
The estimated average economic cost of influenza in the United States exceeds $1 billion each year, and the actual cost is more likely on the order of $3 to $5 billion per year. Benefit-cost models generally indicate that the benefits of influenza immunization for persons aged 65 and over outweigh the cost (when one excludes the cost of medical care in the additional years of healthy life gained by immunization). The low acceptance of influenza immunization suggests that individuals do not see the benefit-cost equation in the same way that policymakers do. This article presents a benefit-cost equation from an individual's perspective. The model demonstrates that pre-season immunization is cost-effective when the cost of a case of influenza, were it to occur, would be very high--as it is in persons under active medical care for heart or lung disease, for example. Immunization is also cost-effective for persons with a high income and a low cost of immunization--such as physicians themselves. The model further demonstrates that in the face of an actual epidemic, one can justify greater expenditures on protection against influenza, including immunization plus chemoprophylaxis or early chemotherapy. Finally, analysis of the model suggests the need for improved, less expensive systems for protecting individuals against influenza.
在美国，每年流感的估计平均经济成本超过10亿美元，而实际成本每年更可能在30亿至50亿美元之间。效益成本模型通常表明，65岁及以上人群接种流感疫苗的益处超过成本（当排除因接种疫苗而多获得的健康生命年限中的医疗护理成本时）。流感疫苗接种的低接受率表明，个人看待效益成本等式的方式与政策制定者不同。本文从个人角度提出了一个效益成本等式。该模型表明，当万一感染流感的病例成本非常高时——例如在接受心脏病或肺病积极医疗护理的人群中——季前接种疫苗具有成本效益。对于高收入且接种成本低的人群——比如医生自身——接种疫苗也具有成本效益。该模型进一步表明，面对实际的疫情时，人们有理由在预防流感方面投入更多支出，包括接种疫苗加化学预防或早期化疗。最后，对该模型的分析表明需要改进成本更低的系统来保护个人预防流感。
