在冰岛儿童免疫规划中引入 10 价肺炎球菌结合疫苗的影响和成本效益：基于人群的时间序列分析。
The impact and cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine into the paediatric immunisation programme in Iceland-A population-based time series analysis.
机构信息
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Faculty of Economics, University of Iceland, Reykjavik, Iceland.
出版信息
PLoS One. 2021 Apr 8;16(4):e0249497. doi: 10.1371/journal.pone.0249497. eCollection 2021.
INTRODUCTION
Streptococcus pneumoniae is a cause of infections that range in severity from acute otitis media (AOM) to pneumonia and invasive pneumococcal disease (IPD). The 10-valent pneumococcal conjugate vaccine (PHiD-CV10) was introduced into the Icelandic paediatric immunisation programme in 2011. The aim was to estimate the population impact and cost-effectiveness of PHiD-CV10 introduction.
METHODS
Data on primary care visits from 2005-2015 and hospitalisations from 2005-2017 were obtained from population-based registries. A Bayesian time series analysis with synthetic controls was employed to estimate the number of cases of AOM, pneumonia and IPD that would have occurred between 2013-2017, had PHiD-CV10 not been introduced. Prevented cases were calculated by subtracting the observed number of cases from this estimate. The cost of the programme was calculated accounting for cost-savings due to prevented cases.
RESULTS
The introduction of PHiD-CV10 prevented 13,767 (95% credible interval [CI] 2,511-29,410) visits for AOM from 2013-2015, and prevented 1,814 (95%CI -523-4,512) hospitalisations for pneumonia and 53 (95%CI -17-177) admissions for IPD from 2013-2017. Visits for AOM decreased both among young children and among children 4-19 years of age, with rate ratios between 0.72-0.89. Decreases were observed in both pneumonia hospitalisations (rate ratios between 0.67-0.92) and IPD (rate ratios between 0.27-0.94). The total cost of implementing PHiD-CV10 in Iceland was -7,463,176 United States Dollars (USD) (95%CI -16,159,551-582,135) with 2.1 USD (95%CI 0.2-4.7) saved for every 1 USD spent.
CONCLUSIONS
The introduction of PHiD-CV10 was associated with large decreases in visits and hospitalisations for infections commonly caused by pneumococcus and was cost-saving during the first five years of the immunisation programme.
简介
肺炎链球菌可引起各种感染，严重程度从急性中耳炎（AOM）到肺炎和侵袭性肺炎球菌病（IPD）不等。10 价肺炎球菌结合疫苗（PHiD-CV10）于 2011 年被引入冰岛儿科免疫计划。目的是估计 PHiD-CV10 引入的人群影响和成本效益。
方法
从基于人群的登记处获得了 2005-2015 年的初级保健就诊数据和 2005-2017 年的住院数据。采用贝叶斯时间序列分析和合成对照来估计如果没有引入 PHiD-CV10，2013-2017 年期间 AOM、肺炎和 IPD 的病例数。通过从该估计中减去观察到的病例数来计算预防的病例数。考虑到预防病例的成本节省，计算了该计划的成本。
结果
PHiD-CV10 的引入预防了 2013-2015 年期间 13767 次（95%可信区间[CI] 2511-29410）AOM 就诊，预防了 2013-2017 年期间 1814 次（95%CI-523-4512）肺炎住院和 53 次（95%CI-17-177）侵袭性肺炎球菌病住院。AOM 就诊量在幼儿和 4-19 岁儿童中均有所下降，比率介于 0.72-0.89 之间。肺炎住院治疗（比率介于 0.67-0.92 之间）和 IPD（比率介于 0.27-0.94 之间）也有所减少。在冰岛实施 PHiD-CV10 的总成本为-7463176 美元（USD）（95%CI-160000000-582135000），每花费 1 美元可节省 2.1 美元（95%CI 0.2-4.7）。
结论
PHiD-CV10 的引入与由肺炎球菌引起的感染就诊和住院人数大幅减少有关，并且在免疫计划的头五年是节省成本的。
Zotero 插件