Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA.
Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
J Med Econ. 2021 Nov;24(sup1):1-13. doi: 10.1080/13696998.2021.2002092.
With the increasing occurrence of infectious diseases in lower-and-middle-income countries (LMICs), emergency preparedness is essential for rapid response and mitigation. Economic evaluations of mitigation technologies and strategies have been recommended for inclusion in emergency preparedness plans. We aimed to perform an economic evaluation using dynamic transition modeling of ebola virus disease (EVD) vaccination in a hypothetical community of 1,000 persons in the Democratic Republic of Congo (DRC).
Using a modified SEIR (Susceptible, Exposed, Infectious, Recovered, with Death added [SEIR-D]) model that accounted for death and epidemiological data from an EVD outbreak in the DRC, we modeled the transmission of EVD in a hypothetical population of 1,000. With our model, we estimated the cost-effectiveness of an EVD vaccine and an EVD vaccination intervention.
The results showed vaccinating 50% of the population at risk prevented 670 cases, 538 deaths, and 22,022 disability-adjusted life years (DALYs). The vaccine was found to be cost-effective with an incremental cost-effectiveness ratio (ICER) of $95.63 per DALY averted. We also determined the minimum required vaccination coverage for cost-effectiveness to be 40%. Sensitivity analysis showed our model to be fairly robust, assuring relatively consistent results even with variations in such input parameters as cost of screening, as well as transmission, infection, incubation, and case fatality rates.
EVD vaccination in our hypothetical population was found to be cost-effective from the payer perspective. Our model presents an efficient and reliable approach for conducting economic evaluations of infectious disease interventions as part of an emergency preparedness plan.
随着中低收入国家（LMICs）传染病的发生率不断增加，紧急准备对于快速应对和缓解至关重要。已经建议在紧急准备计划中纳入减轻技术和策略的经济评估。我们旨在使用刚果民主共和国（DRC）一个 1000 人的假想社区中埃博拉病毒病（EVD）疫苗接种的动态过渡建模来进行经济评估。
使用一种修改后的 SEIR（易感，暴露，感染，恢复，添加死亡[SEIR-D]）模型，该模型考虑了来自刚果民主共和国 EVD 暴发的死亡和流行病学数据，我们对 1000 人的假想人群进行了 EVD 的传播建模。使用我们的模型，我们估计了 EVD 疫苗和 EVD 疫苗接种干预措施的成本效益。
结果表明，对 50％的高危人群进行疫苗接种可预防 670 例，538 例死亡和 22,022 个伤残调整生命年（DALY）。疫苗的增量成本效益比（ICER）为每避免一个 DALY 需 95.63 美元，具有成本效益。我们还确定了成本效益所需的最低疫苗接种覆盖率为 40％。敏感性分析表明，即使输入参数（如筛查成本）以及传播，感染，潜伏期和病死率发生变化，我们的模型也相当稳健，可确保结果相对一致。
从付款人的角度来看，我们假想人群中的 EVD 疫苗接种具有成本效益。我们的模型为作为紧急准备计划一部分的传染病干预措施的经济评估提供了一种有效且可靠的方法。
