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干预重大传染病威胁的成本和效益:文献中的经验教训。

Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature.

机构信息

Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

出版信息

Eur J Health Econ. 2020 Dec;21(9):1329-1350. doi: 10.1007/s10198-020-01218-4. Epub 2020 Aug 13.

DOI:10.1007/s10198-020-01218-4
PMID:32789780
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7425274/
Abstract

Pandemics and major outbreaks have the potential to cause large health losses and major economic costs. To prioritize between preventive and responsive interventions, it is important to understand the costs and health losses interventions may prevent. We review the literature, investigating the type of studies performed, the costs and benefits included, and the methods employed against perceived major outbreak threats. We searched PubMed and SCOPUS for studies concerning the outbreaks of SARS in 2003, H5N1 in 2003, H1N1 in 2009, Cholera in Haiti in 2010, MERS-CoV in 2013, H7N9 in 2013, and Ebola in West-Africa in 2014. We screened titles and abstracts of papers, and subsequently examined remaining full-text papers. Data were extracted according to a pre-constructed protocol. We included 34 studies of which the majority evaluated interventions related to the H1N1 outbreak in a high-income setting. Most interventions concerned pharmaceuticals. Included costs and benefits, as well as the methods applied, varied substantially between studies. Most studies used a short time horizon and did not include future costs and benefits. We found substantial variation in the included elements and methods used. Policymakers need to be aware of this and the bias toward high-income countries and pharmaceutical interventions, which hampers generalizability. More standardization of included elements, methodology, and reporting would improve economic evaluations and their usefulness for policy.

摘要

大流行病和重大疫情有可能造成大量健康损失和重大经济成本。为了在预防和应对干预措施之间进行优先排序,了解干预措施可能预防的成本和健康损失非常重要。我们回顾了文献,研究了所进行的研究类型、所包括的成本和效益,以及针对被认为是重大疫情威胁所采用的方法。我们在 PubMed 和 SCOPUS 上搜索了有关 2003 年 SARS 爆发、2003 年 H5N1、2009 年 H1N1、2010 年海地霍乱、2013 年 MERS-CoV、2013 年 H7N9 和 2014 年西非埃博拉的爆发的研究。我们筛选了论文的标题和摘要,然后检查了剩余的全文论文。根据预先构建的方案提取数据。我们共纳入了 34 项研究,其中大多数评估了高收入环境中与 H1N1 疫情相关的干预措施。大多数干预措施涉及药品。纳入的成本和效益以及所采用的方法在研究之间有很大差异。大多数研究采用了短期视角,并未纳入未来的成本和效益。我们发现所纳入的要素和使用的方法存在很大差异。决策者需要意识到这一点,以及偏向于高收入国家和药物干预的偏见,这会阻碍其推广。纳入要素、方法和报告的标准化将提高经济评估及其对政策的有用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77f4/7581589/40c18b336a18/10198_2020_1218_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77f4/7581589/40c18b336a18/10198_2020_1218_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77f4/7581589/40c18b336a18/10198_2020_1218_Fig1_HTML.jpg

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