Harris A, Hendrie D, Bower C, Payne J, de Klerk N, Stanley F
University of Western Australia, Department of Public Health, Queen Elizabeth II Medical Centre, Nedlands.
Med J Aust. 1994 Apr 18;160(8):483-8.
To estimate the incidence and sequelae of Haemophilus influenzae type b disease (Hib) in the Australian population, and to evaluate the costs and outcomes of a vaccination program using the vaccine PRP-OMP at two, four and 12 months.
The evaluation was based on a decision analytic model developed by Merck Sharp and Dohme (Australia) Pty Ltd, to predict the number of children who would contract Hib, and suffer mild or severe sequelae or die as a result. The state of health of a cohort of children was modelled each month over a five-year period. A survey of medical records and interviews with parents of children who contracted meningitis in Western Australia from 1984-1990 was undertaken to provide data on the extent and costs of sequelae.
The incidence of Hib among non-Aboriginal Australians under five years of age was estimated as 53 per 100,000, and 460 per 100,000 among Aborigines. In a single year at least 630 children may contract Hib, up to 19 may die, and a further 46 may have neurological damage, this being severe in up to 18 children. The number of deaths could be reduced by 17 per year and a further 25 cases of severe and 16 cases of mild disability could be averted. At a price of $20 per dose, and a 5% discount rate, the expected cost per year of life extended by a vaccination program is $3148. When adjusted for the increased number of years without neurological impairment, the incremental cost per quality adjusted life year (QALY) is $1965. Compared with a single vaccine at 18 months, the incremental cost per additional QALY gained is $5047. A separate analysis of the Aboriginal population showed that the proposed vaccination program would be of significant benefit, leading to a saving of resources.
评估澳大利亚人群中b型流感嗜血杆菌疾病（Hib）的发病率及后遗症情况，并评估在2个月、4个月和12个月时使用PRP - OMP疫苗的疫苗接种计划的成本及效果。
该评估基于默克夏普和多贺美（澳大利亚）私人有限公司开发的决策分析模型，以预测感染Hib、出现轻度或重度后遗症或死亡的儿童数量。在五年期间，每月对一组儿童的健康状况进行建模。对1984 - 1990年西澳大利亚州患脑膜炎儿童的病历进行调查，并对其父母进行访谈，以获取后遗症程度和成本的数据。
估计五岁以下非原住民澳大利亚人中Hib的发病率为每10万人53例，原住民中为每10万人460例。在单一年度，至少630名儿童可能感染Hib，多达19名儿童可能死亡，另有46名儿童可能出现神经损伤，其中多达18名儿童损伤严重。每年死亡人数可减少17名，还可避免另外25例严重残疾和16例轻度残疾病例。每剂疫苗价格为20美元，贴现率为5%，疫苗接种计划每年延长生命的预期成本为3148美元。经无神经损伤年限增加调整后，每质量调整生命年（QALY）的增量成本为1965美元。与18个月时接种单一疫苗相比，每增加一个QALY的增量成本为5047美元。对原住民人群的单独分析表明，拟议的疫苗接种计划将带来显著益处，可节省资源。
