Willems J S, Sanders C R, Riddiough M A, Bell J C
N Engl J Med. 1980 Sep 4;303(10):553-9. doi: 10.1056/NEJM198009043031004.
We used cost-effectiveness analysis to examine the medical-care costs of vaccination against pneumococcal pneumonia in relation to its effects on health. Vaccination could add a year of healthy life among all age groups for about $4,800 in net medical-care costs. Cost-effectiveness ratios vary according to the age of the person vaccinated--from $1,000 per year of healthy life for an adult 65 years old or older to $77,000 per year of healthy life for a child between the ages of two and four. These ratios may change substantially with variations in such factors as the cost of vaccination, the duration of immunity, the efficacy and composition of the vaccine, and the percentage of pneumonia that is pneumococcal. This analysis has particular relevance for the Medicare program, since present legislation excludes coverage of most immunizations and other preventive services. Provision of pneumococcal vaccine to the elderly and inclusion of the vaccine as a Medicare benefit merit serious consideration.
我们采用成本效益分析方法，研究了肺炎球菌肺炎疫苗接种的医疗成本及其对健康的影响。接种疫苗可为所有年龄组增加一年健康寿命，净医疗成本约为4800美元。成本效益比因接种疫苗者的年龄而异——65岁及以上成年人每增加一年健康寿命的成本为1000美元，2至4岁儿童则为每年77000美元。这些比率可能会因疫苗接种成本、免疫持续时间、疫苗效力和成分以及肺炎球菌性肺炎所占百分比等因素的变化而大幅改变。该分析对医疗保险计划尤为重要，因为现行立法不包括大多数免疫接种和其他预防服务。为老年人提供肺炎球菌疫苗并将其纳入医疗保险福利值得认真考虑。
