Liverpool School of Tropical Medicine, Liverpool, England, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, England, UK.
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, England, UK.
Value Health. 2019 Nov;22(11):1329-1344. doi: 10.1016/j.jval.2019.06.011. Epub 2019 Sep 10.
Pneumococcal diseases cause substantial mortality, morbidity, and economic burden. Evidence on data inputs for economic evaluations of interventions targeting pneumococcal disease is critical.
To summarize evidence on resource use, costs, health utilities, and cost-effectiveness for pneumococcal disease and associated interventions to inform future economic analyses.
We searched MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, EconLit, and Cochrane databases for peer-reviewed studies in English on pneumococcal disease that reported health utilities using direct or indirect valuation methods, resource use, costs, or cost-effectiveness of intervention programs, and summarized the evidence descriptively.
We included 383 studies: 9 reporting health utilities, 131 resource use, 160 economic costs of pneumococcal disease, 95 both resource use and costs, and 178 economic evaluations of pneumococcal intervention programs. Health state utility values ranged from 0 to 1 for both meningitis and otitis media and from 0.3 to 0.7 for both pneumonia and sepsis. Hospitalization was shortest for otitis media (range: 0.1-5 days) and longest for sepsis/septicemia (6-48). The main categories of costs reported were drugs, hospitalization, and household or employer costs. Resource use was reported in hospital length of stay and number of contacts with general practitioners. Costs and resource use significantly varied among population ages, disease conditions, and settings. Current vaccination programs for both adults and children, antibiotic use and outreach programs to promote vaccination, early disease detection, and educational programs are cost-effective in most countries.
This study has generated a comprehensive repository of health economic evidence on pneumococcal disease that can be used to inform future economic evaluations of pneumococcal disease intervention programs.
肺炎球菌疾病会导致大量的死亡、发病和经济负担。针对肺炎球菌疾病的干预措施进行经济评估的数据投入的证据至关重要。
总结肺炎球菌疾病及其相关干预措施的资源利用、成本、健康效用和成本效益证据，为未来的经济分析提供信息。
我们检索了 MEDLINE、Embase、Web of Science、CINAHL、PsycINFO、EconLit 和 Cochrane 数据库，以获取关于肺炎球菌疾病的同行评议研究，这些研究报告了使用直接或间接估值方法、干预计划的资源利用、成本或成本效益的健康效用，并对证据进行了描述性总结。
我们纳入了 383 项研究：9 项报告健康效用，131 项报告资源利用，160 项报告肺炎球菌疾病的经济成本，95 项同时报告资源利用和成本，178 项报告肺炎球菌干预计划的经济评估。脑膜炎和中耳炎的健康状态效用值范围为 0 至 1，肺炎和败血症的健康状态效用值范围为 0.3 至 0.7。中耳炎的住院时间最短（范围：0.1-5 天），败血症/败血症最长（6-48 天）。报告的主要成本类别是药物、住院和家庭或雇主成本。资源利用报告了住院时间和与全科医生的接触次数。不同人群年龄、疾病状况和环境下，资源利用和成本有显著差异。目前针对成人和儿童的疫苗接种计划、抗生素使用以及促进疫苗接种、早期疾病检测和教育计划的推广计划在大多数国家都是具有成本效益的。
本研究生成了一个关于肺炎球菌疾病的综合健康经济证据库，可用于为未来的肺炎球菌疾病干预措施经济评估提供信息。
