Guyatt H L, Evans D
Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel.
Acta Trop. 1995 Jun;59(3):197-209. doi: 10.1016/0001-706x(95)91938-5.
This paper investigates some of the characteristics which a vaccine for schistosomiasis would require to be more cost-effective than chemotherapy. The impact of a variety of possible vaccination scenarios are assessed in terms of the discounted years of heavy infection prevented in children, and the cost-effectiveness of these approaches are compared with annual mass treatment. The analyses demonstrate that the three critical parameters determining whether a vaccine would ever be more cost-effective than mass chemotherapy are price, duration of protection and efficacy. If the vaccine had sufficient duration of protection to be delivered through the regular childhood immunization programmes (EPI), it could be more cost-effective than annual chemotherapy. The necessary condition is that adding the vaccine to EPI must not cost more than $4.30 per person in excess of one round of chemotherapy. For a shorter duration of vaccine protection, the schistosomiasis vaccine could not exceed the cost (including delivery costs) of one round of annual chemotherapy by more than approximately $3.50.
本文研究了血吸虫病疫苗要比化疗更具成本效益所需具备的一些特性。根据预防儿童重度感染的贴现年数评估了各种可能的疫苗接种方案的影响，并将这些方法的成本效益与年度群体治疗进行了比较。分析表明，决定疫苗是否比群体化疗更具成本效益的三个关键参数是价格、保护期和效力。如果疫苗具有足够的保护期，能够通过常规儿童免疫规划（EPI）进行接种，那么它可能比年度化疗更具成本效益。必要条件是，在EPI中添加疫苗每人的成本不得超过一轮化疗成本4.30美元。对于较短的疫苗保护期，血吸虫病疫苗的成本（包括交付成本）超过一轮年度化疗成本的幅度不能超过约3.50美元。
