Ray Shomik, Pathak Sukanya, Kshtriya Pranav
Department of Research, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, Haryana, India.
Department of Research, Indian Institute of Public Health-Delhi, Public Health Foundation of India, Gurgaon, Haryana, India.
Value Health Reg Issues. 2023 Nov;38:18-28. doi: 10.1016/j.vhri.2023.06.003. Epub 2023 Jul 10.
To identify, critically appraise, and summarize the use of different methods and results of economic evaluations to assess the efficiency of rotavirus vaccination programs in low- and lower-middle-income countries.
A systematic literature search was performed in 3 bibliographic databases, including PubMed, ProQuest, Cochrane Library, and Science Direct (Elsevier) journal website, using key search terms. The study selection process was based on predefined inclusion criteria. The search results were presented using the research flow diagram based on guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The quality assessment of the selected studies was carried out using the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist.
A total of 21 studies were selected for review. All the studies, except 1, reported rotavirus vaccination to be a cost-effective intervention and a high-impact strategy to reduce substantial rotavirus disease burden. A decision analysis model was considered appropriate by all studies, although there were variabilities in the analytic horizon used. Lack of country-level data was highlighted by most studies. Multiples of gross domestic product of respective countries were used as a threshold to interpret cost-effectiveness.
Rotavirus vaccination was found to be cost-efficient in most settings, including complex humanitarian emergencies. The use of thresholds for interpreting incremental cost-effectiveness ratios and lack of local-level disease incidence and cost of illness data remains a point of contention. Lack of reporting probabilistic sensitivity analysis renders limited robustness to study results.
识别、严格评估并总结在低收入和中低收入国家评估轮状病毒疫苗接种计划效率时不同经济评估方法的使用情况及结果。
使用关键检索词在3个文献数据库中进行系统文献检索，包括PubMed、ProQuest、Cochrane图书馆以及Science Direct（爱思唯尔）期刊网站。研究选择过程基于预先定义的纳入标准。检索结果根据PRISMA（系统评价和Meta分析的首选报告项目）指南用研究流程图呈现。使用CHEERS（卫生经济评估报告标准合并清单）对所选研究进行质量评估。
共选择21项研究进行综述。除1项研究外，所有研究均报告轮状病毒疫苗接种是一种具有成本效益的干预措施，也是减轻轮状病毒疾病负担的一项高影响力策略。尽管所用分析期限存在差异，但所有研究都认为决策分析模型是合适的。大多数研究都强调缺乏国家层面的数据。各国国内生产总值的倍数被用作解释成本效益的阈值。
在大多数情况下，包括复杂的人道主义紧急情况，轮状病毒疫苗接种被发现具有成本效益。在解释增量成本效益比时使用阈值以及缺乏地方层面疾病发病率和疾病成本数据仍是一个争议点。缺乏概率敏感性分析报告使得研究结果的稳健性有限。
