Wilson Michele R, Wasserman Matthew D, Breton Marie-Claude, Peloquin Francois, Earnshaw Stephanie R, McDade Cheryl, Sings Heather L, Farkouh Raymond A
RTI Health Solutions, Research Triangle Park, NC, USA.
Pfizer, Inc, New York, NY, USA.
Infect Dis Ther. 2020 Jun;9(2):341-353. doi: 10.1007/s40121-020-00294-6. Epub 2020 Apr 8.
A model was developed to estimate the historical impact (including total societal health and economic benefit) of pneumococcal conjugate vaccine (PCV) programs in the overall Canadian population between 2005 and 2015, inclusively.
Historical incidence of invasive pneumococcal disease (IPD), pneumonia, and acute otitis media (AOM) were obtained from epidemiologic databases supplemented with published and unpublished data. Two scenarios were considered: (1) the observed historical incidence from 2005 to 2015 in the setting of PCV use; (2) a hypothetical scenario in which we estimated the number of disease cases assuming no PCV use. Disease cases averted as a result of PCV programs were calculated by subtracting the number of observed historical cases from the number of estimated cases expected in the absence of PCV use.
PCV programs were estimated to have saved 6631 lives and averted 14,990 IPD cases, 735,700 pneumonia episodes, and 3,697,993 AOM episodes. Positive clinical outcomes resulted in total cost savings of CAD $1.76 billion over 11 years. Vaccination costs were offset by the direct medical cost savings from fewer cases of IPD, pneumonia, and AOM.
Canadian PCV programs have provided significant health benefits and resulted in a substantial value for money. Net savings achieved over the reviewed period would have provided funding for $1.76 billion in other health care costs or public health initiatives. These findings highlight the importance of considering the total value of a vaccination program, rather than vaccine acquisition costs only, when assessing the value of immunization programs.
建立一个模型，以估计2005年至2015年（含）期间肺炎球菌结合疫苗（PCV）计划对加拿大全体人口的历史影响（包括总体社会健康和经济效益）。
侵袭性肺炎球菌病（IPD）、肺炎和急性中耳炎（AOM）的历史发病率来自流行病学数据库，并补充了已发表和未发表的数据。考虑了两种情况：（1）2005年至2015年在使用PCV的情况下观察到的历史发病率；（2）假设未使用PCV时估计疾病病例数的假设情况。通过从假设未使用PCV时预期的估计病例数中减去观察到的历史病例数，计算出PCV计划避免的疾病病例数。
估计PCV计划挽救了6631条生命，避免了14990例IPD病例、735700例肺炎发作和3697993例AOM发作。积极的临床结果在11年内总共节省了17.6亿加元的成本。疫苗接种成本被IPD、肺炎和AOM病例减少带来的直接医疗成本节省所抵消。
加拿大的PCV计划带来了显著的健康益处，并产生了巨大的性价比。在审查期间实现的净节省可为17.6亿加元的其他医疗保健成本或公共卫生举措提供资金。这些发现突出了在评估免疫计划的价值时，考虑疫苗接种计划的总价值而非仅疫苗购置成本的重要性。
