军队中水痘疫苗的卫生技术评估
Health technology assessment of varicella vaccine in the Armed Forces.
作者信息
Patrikar Seema, Bhatti V K, Suryam Vani, Kotwal A, Basannar D R, Khera A, Kashyap Surekha, Sharma Ashutosh
机构信息
Senior Lecturer in Statistics, Department of Community Medicine, Armed Forces Medical College, Pune, India.
Brig Medical, HQ 17 Corps, C/o 99 APO, India.
出版信息
Med J Armed Forces India. 2022 Apr;78(2):213-220. doi: 10.1016/j.mjafi.2021.06.010. Epub 2021 Aug 13.
BACKGROUND
The Indian Armed Forces, on entry, vaccinates all cadets and recruits with varicella vaccine for the prevention of varicella. This health technology assessment (HTA) report puts forth evidence for HTA of varicella vaccination in the Armed Forces in various domains namely clinical, societal, ethical, economic, and legal.
METHODS
The policy question under each domain has been developed according to best-practice methods for HTA. The costs included were hospitalization cost due to varicella infection; training lost cost; the varicella vaccine cost; cost of the side effects of vaccine; and the outbreak investigation cost. The incremental cost-effectiveness ratio (ICER) for varicella cases averted and man-days saved, and quality-adjusted life years (QALYs) gained due to varicella vaccination strategy were calculated.
RESULTS
Evidence suggests a reduction of 81% in hospitalization rates with 19392 man-days saved per 1 lakh population due to varicella vaccination strategy. The ICER for varicella cases averted is estimated to be Rs 56732/- per case averted and Rs 5687/- per man-day saved. QALYs gained due to two-dose varicella vaccination strategy is estimated to be 1152 per 1 lakh population with cost per QALY gained Rs 95735/-.
CONCLUSION
The study showed a large reduction in hospitalizations and consequently man-days lost after the introduction of the vaccination strategy. The QALYs was another aspect of importance brought out by this study. Thus, a two-dose vaccination strategy for varicella-zoster virus (VZV) for the Armed Forces trainees is a cost-effective policy.
背景
印度武装部队在新兵入伍时，会为所有学员和新兵接种水痘疫苗以预防水痘。这份卫生技术评估（HTA）报告提出了在临床、社会、伦理、经济和法律等各个领域对武装部队水痘疫苗接种进行卫生技术评估的证据。
方法
每个领域的政策问题均按照卫生技术评估的最佳实践方法制定。所包含的成本有因水痘感染导致的住院费用、培训损失成本、水痘疫苗成本、疫苗副作用成本以及疫情调查成本。计算了因水痘疫苗接种策略避免的水痘病例和节省的人日数的增量成本效益比（ICER），以及获得的质量调整生命年（QALY）。
结果
有证据表明，由于水痘疫苗接种策略，住院率降低了81%，每10万人口节省了19392个工作日。估计避免一例水痘病例的ICER为56732卢比/例，每节省一个工作日为5687卢比。两剂水痘疫苗接种策略使每10万人口获得的QALY估计为1152个，每获得一个QALY的成本为95735卢比。
结论
该研究表明，接种疫苗策略实施后，住院人数大幅减少，进而减少了工作日损失。QALY是本研究凸显的另一个重要方面。因此，为武装部队学员实施的两剂水痘 - 带状疱疹病毒（VZV）疫苗接种策略是一项具有成本效益的政策。
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