Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.
Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China.
Front Public Health. 2023 Mar 7;11:1037556. doi: 10.3389/fpubh.2023.1037556. eCollection 2023.
Since September 2020, Chinese populations aged > 3 years have been encouraged to receive a two-dose inoculation with vaccines against coronavirus disease 2019 (COVID-19). This study aims to evaluate the cost-effectiveness of the current vaccination strategy amongst the general population in mainland China from a societal perspective.
In this study, we construct a decision tree with Markov models to compare the economic and health consequences of the current vaccination strategy versus a no-vaccination scenario, over a time horizon of one year and an annual discount rate of 5%. Transition probabilities, health utilities, healthcare costs, and productivity losses are estimated from literature. Outcome measures include infection rates, death rates, quality-adjusted life years (QALYs), and costs. The incremental cost-effectiveness ratio (ICER) is then calculated to evaluate the cost-effectiveness of the current vaccination strategy, and both one-way deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA) are applied to assess the impact of uncertainties on results.
Our simulation indicates that compared with a no-vaccination scenario, vaccination amongst the general population in mainland China would reduce the infection rate from 100% to 45.3% and decrease the death rate from 6.8% to 3.1%. Consequently, the strategy will lead to a saving of 37,664.77 CNY (US$5,256.70) and a gain of 0.50 QALYs per person per year on average (lifetime QALY and productivity loss due to immature death are included). The cost-saving for each QALY gain is 74,895.69 CNY (US$10,452.85). Result of the PSA indicates that vaccination is the dominating strategy with a probability of 97.9%, and the strategy is cost-effective with a probability of 98.5% when the willingness-to-pay (WTP) is 72,000 CNY (US$10,048.71) per QALY.
Compared with a no-vaccination scenario, vaccination among the general population in mainland China is the dominating strategy from a societal perspective. The conclusion is considered robust in the sensitivity analyses.
自 2020 年 9 月以来，中国 3 岁以上人群被鼓励接种两剂针对 2019 年冠状病毒病（COVID-19）的疫苗。本研究旨在从社会角度评估中国大陆一般人群目前的疫苗接种策略的成本效益。
本研究采用决策树与马尔可夫模型构建，比较了当前疫苗接种策略与不接种疫苗方案在一年时间内的经济和健康后果，贴现率为每年 5%。转移概率、健康效用、医疗保健成本和生产力损失均来自文献。结果衡量标准包括感染率、死亡率、质量调整生命年（QALY）和成本。然后计算增量成本效益比（ICER），以评估当前疫苗接种策略的成本效益，并进行单因素确定性敏感性分析和概率敏感性分析（PSA），以评估不确定性对结果的影响。
我们的模拟表明，与不接种疫苗方案相比，在中国大陆一般人群中进行疫苗接种将使感染率从 100%降至 45.3%，死亡率从 6.8%降至 3.1%。因此，该策略将平均每人每年节省 37664.77 元人民币（5256.70 美元），并获得 0.50 个质量调整生命年（包括不成熟死亡导致的生命质量损失和生产力损失）。每获得一个质量调整生命年的成本节约为 74895.69 元人民币（10452.85 美元）。PSA 的结果表明，疫苗接种是一种主导策略，概率为 97.9%，当意愿支付（WTP）为 72000 元人民币（10048.71 美元）/QALY 时，疫苗接种方案具有成本效益的概率为 98.5%。
与不接种疫苗方案相比，中国大陆一般人群的疫苗接种是一种具有社会意义的主导策略。在敏感性分析中，该结论被认为是稳健的。
