Smith J C, Haddix A C, Teutsch S M, Glass R I
Viral Gastroenteritis Section, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Pediatrics. 1995 Oct;96(4 Pt 1):609-15.
To estimate the economic consequences in the United States of routine childhood immunization of children younger than 1 year of age with a rotavirus (RV) vaccine.
Cost-effectiveness analysis of a national RV immunization program from the perspective of the health care system and the perspective of society. Estimates of disease incidence, medical expenditures, productivity costs, vaccine efficacy, and vaccine coverage rates were derived from published literature and unpublished vaccine trial reports. The impact of changes in estimates of vaccine efficacy and medical costs was determined by sensitivity analysis.
Incremental cost effectiveness, expressed as savings per case of RV diarrhea prevented.
Given a vaccine efficacy rate of 50% and a vaccine cost of $30 per dose, an RV immunization program would prevent more than 1 million cases of RV diarrhea, 58,000 hospitalizations, and 82 deaths per year. A vaccine program would cost $243 million per year but would yield net savings of $79 million from the perspective of the health care system and $466 million from the perspective of society. The incremental cost effectiveness was a savings of $459 per case prevented from the societal perspective and $78 per case prevented from the health care system perspective. Sensitivity analyses substantiated net savings over a wide range of variables, and cost effectiveness increased with greater vaccine efficacy or decreased vaccine cost.
Economic and disease reduction benefits would be realized from the use of an RV vaccine that is partially protective against severe RV diarrhea. These findings suggest that immunization with an RV vaccine would be cost effective and cost saving.
评估在美国对1岁以下儿童常规接种轮状病毒（RV）疫苗的经济后果。
从医疗保健系统和社会角度对全国RV免疫计划进行成本效益分析。疾病发病率、医疗支出、生产力成本、疫苗效力和疫苗接种率的估计值来自已发表的文献和未发表的疫苗试验报告。通过敏感性分析确定疫苗效力和医疗成本估计值变化的影响。
增量成本效益，以每预防一例RV腹泻所节省的费用表示。
假设疫苗效力为50%，每剂疫苗成本为30美元，RV免疫计划每年可预防超过100万例RV腹泻、58000例住院治疗和82例死亡。疫苗计划每年将花费2.43亿美元，但从医疗保健系统角度来看将产生7900万美元的净节省，从社会角度来看将产生4.66亿美元的净节省。从社会角度来看，增量成本效益是每预防一例节省459美元，从医疗保健系统角度来看是每预防一例节省78美元。敏感性分析证实了在广泛的变量范围内都有净节省，并且成本效益随着疫苗效力提高或疫苗成本降低而增加。
使用对严重RV腹泻有部分保护作用的RV疫苗将实现经济和疾病减少效益。这些发现表明，接种RV疫苗具有成本效益且能节省成本。
