Graham Jonathan, Wolfson Lara J, Kyle Jeffrey, Bolde-Villarreal Carlos Perez, Guarneros-DeRegil Diana B, Monsanto Homero, Pillsbury Matthew, Talbird Sandra, Daniels Vincent J
Health Economics, Research Triangle Park, RTI Health Solutions, NC, USA.
Center for Observational and Real World Evidence (CORE), Merck & Co., Inc, Kenilworth, NJ, USA.
Hum Vaccin Immunother. 2020 Apr 2;16(4):886-894. doi: 10.1080/21645515.2019.1672491. Epub 2019 Dec 18.
A number of live-attenuated varicella vaccines are produced globally that provide protection against the varicella zoster virus. In Mexico, varicella vaccination is not included in the national immunization program and is recommended for use only in high-risk subgroups. We developed a budget impact model to estimate the impact of universal childhood immunization against varicella on the national payer system in Mexico. A scenario of no varicella vaccination was compared to scenarios with vaccination with a single dose at 13 months of age, in alignment with the existing program of immunization with the measles-mumps-rubella vaccine. Nine different vaccination scenarios were envisioned, differing by vaccine type and by coverage. Varicella cases and treatment costs of each scenario were computed in a dynamic transmission model of varicella epidemiology, calibrated to the population of Mexico. Unit costs were based on Mexico sources or were from the literature. The results indicated that each of the three vaccine types increased vaccine acquisition and administration expenditures but produced overall cost savings in each of the first 10 years of the program, due to fewer cases and reduced varicella treatment costs. A highly effective vaccine at 95% coverage produced the greatest cost savings.
全球生产了多种减毒活水痘疫苗，可预防水痘带状疱疹病毒。在墨西哥，水痘疫苗未纳入国家免疫规划，仅建议在高危亚组中使用。我们建立了一个预算影响模型，以估计在墨西哥全国范围内对儿童进行水痘普遍免疫对支付系统的影响。将未接种水痘疫苗的情况与在13个月龄时接种一剂疫苗的情况进行了比较，这与现有的麻疹-腮腺炎-风疹疫苗免疫规划相一致。设想了九种不同的疫苗接种情况，因疫苗类型和覆盖率而异。在根据墨西哥人口校准的水痘流行病学动态传播模型中计算了每种情况的水痘病例数和治疗成本。单位成本基于墨西哥的资料来源或文献。结果表明，三种疫苗类型中的每一种都增加了疫苗采购和管理支出，但由于病例减少和水痘治疗成本降低，在该规划的前10年中每年都产生了总体成本节约。覆盖率为95%的高效疫苗产生的成本节约最大。
