Faculty of Pharmaceutical Sciences, Department of Social and Administrative Pharmacy, Chulalongkorn University, Bangkok, Thailand.
Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
Appl Health Econ Health Policy. 2020 Aug;18(4):579-587. doi: 10.1007/s40258-020-00553-0.
Pneumococcal diseases were estimated to cause 1.6 million deaths annually worldwide in 2008, with approximately half of these occurring in children aged under 5 years. The consequences and deaths adversely impact individuals' and caregivers' work productivity.
This study aimed to quantify the potential lifetime productivity loss due to pneumococcal diseases among the pediatric population in Thailand using productivity-adjusted life years (PALYs).
A decision analytic model was used to estimate the burden of pneumococcal diseases among the current Thai population aged 0-5 years and followed up until aged 99 years or death. Base-case analysis compared years of life and PALYs lost to pneumococcal diseases. Scenario analyses investigated the benefits of prevention with pneumococcal conjugated vaccine 13 (PCV 13). All health outcomes were discounted at 3% per annum.
The base-case analysis estimated that 453,401 years of life and 457,598 PALYs would be lost to pneumococcal diseases, equating to a loss of US$5586 (95% CI 3338-10,302) million. Vaccination with PCV13 at birth was estimated to save 82,609 years of life and 93,759 PALYs, which equated to US$1144 (95% CI 367-2591) million in economic benefits. The incidence of pneumonia in those aged 0-4 years, vaccine efficacy, and the assumed period of protection were key determinants of the health economic outputs.
The disease and financial burden of pneumococcal diseases in Thailand is significant, but a large proportion of this is potentially preventable with vaccination.
据估计，2008 年全球每年有 160 万人因肺炎球菌病死亡，其中约一半发生在 5 岁以下儿童中。这些后果和死亡对个人和照顾者的工作生产力产生不利影响。
本研究旨在使用调整后的生产力生命年（PALYs）来量化泰国儿科人群因肺炎球菌病导致的潜在终生生产力损失。
使用决策分析模型来估计当前泰国 0-5 岁人群中肺炎球菌病的负担，并随访至 99 岁或死亡。基础案例分析比较了因肺炎球菌病而失去的生命年和 PALYs。情景分析调查了肺炎球菌结合疫苗 13（PCV13）预防的益处。所有健康结果均按 3%的年利率贴现。
基础案例分析估计，453401 个生命年和 457598 个 PALYs 将因肺炎球菌病而丧失，相当于损失 5586 百万美元（95%CI 3338-10302）。在出生时接种 PCV13 估计可挽救 82609 个生命年和 93759 PALYs，相当于 1.144 亿美元（95%CI 367-2591）的经济效益。0-4 岁人群的肺炎发病率、疫苗效力和假设的保护期是健康经济产出的关键决定因素。
泰国肺炎球菌病的疾病和经济负担是巨大的，但很大一部分可以通过接种疫苗来预防。
