Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen , Groningen , Netherlands.
Department of Clinical and Community Pharmacy, University of Jember , Jember , Indonesia.
Expert Rev Vaccines. 2019 Sep;18(9):897-911. doi: 10.1080/14760584.2019.1651650. Epub 2019 Aug 12.
: Bacillus Calmette-Guérin (BCG) is the only licensed vaccine for tuberculosis, but its effectiveness is limited and varies by age. New candidate vaccines are currently being investigated. In response to the declining incidence of TB, practices relating to BCG vaccination have changed in various countries in recent years. A valid cost-effectiveness study is therefore needed in order to assist decision-makers in the implementation of cost-effective strategies for BCG vaccination. : Studies involving economic evaluations of BCG vaccination were reviewed in order to present current findings concerning a range of BCG vaccination strategies in a variety of regions, target populations, and vaccine types. The Quality of Health Economic Studies (QHES) instrument was used to assess the quality of the studies included in the analysis. : Most of the studies showed a favorable economic profile of BCG vaccination. Selective strategies seem the most cost-effective option for low-incidence areas. Varying results on revaccination strategies did not lead to any conclusive finding on the cost-effectiveness of the strategies. A novel vaccine - either a BCG replacement or booster vaccine that provides better protection, especially in adults - has the potential to enhance the cost-effectiveness of vaccinating against tuberculosis.
卡介苗（BCG）是唯一获准用于结核病的疫苗，但效果有限，并且因年龄而异。目前正在研究新的候选疫苗。近年来，由于结核病发病率下降，各国与卡介苗接种有关的做法发生了变化。因此，需要进行有效的成本效益研究，以帮助决策者实施具有成本效益的卡介苗接种策略。
为了在各种地区、目标人群和疫苗类型中呈现当前关于各种卡介苗接种策略的发现，我们对卡介苗接种的经济评估研究进行了综述。使用健康经济研究质量（QHES）工具评估了分析中包含的研究的质量。
大多数研究表明卡介苗接种具有良好的经济效益。对于低发病率地区，选择性策略似乎是最具成本效益的选择。关于复种策略的不同结果并没有得出关于这些策略成本效益的任何结论性发现。新型疫苗——无论是提供更好保护的 BCG 替代品还是加强疫苗——都有可能提高针对结核病的疫苗接种的成本效益。
