儿童七价肺炎球菌结合疫苗的成本效果分析

发布时间：2018-03-29 22:13

本文选题：七价肺炎球菌结合疫苗　切入点：卫生经济学评价　出处：《中国卫生经济》2013年04期

【摘要】：目的:基于支付方角度,就七价肺炎球菌结合疫苗(PCV7)纳入深圳市城市免疫规划(City Immunization Program,CIP)与否两种情况,对2岁以下儿童注射疫苗在全人群获得的免疫效果和成本效果进行实证研究。方法:疾病负担数据取自深圳市三甲医院2010年肺炎链球菌性疾病患者的电子病历;流行病学病学数据来自台湾健保局肺炎链球菌性疾病法定上报系统;疫苗效果数据来自国内外公开发表的临床试验文献;最后根据接种方案及结果构建的决策树模型和深圳市人口学数据模拟运算,评估实施接种政策后的免疫效果和成本效果。结果:当PCV7未纳入深圳CIP作为二类疫苗使用时,由于较低的接种率和较高的接种价格,结果不具备成本效果优势;当PCV7纳入深圳CIP作为一类疫苗使用时,预测CIP的3+1接种策略每年共可预防36 594人患肺炎链球菌性脑膜炎、肺炎链球菌性菌血症、全因肺炎和全因中耳炎,并可避免162人死亡,共获得2 223个生命年和2 004个质量调整生命年,平均每获得一个质量调整生命年的成本为11.8万元。结论:PCV7纳入深圳CIP后,能大幅降低儿童及成人肺炎球菌相关疾病及死亡。根据WHO对药物经济学评价的推荐意见,其介于我国1倍至3倍的人均GDP间,认为具有成本效果优势。
[Abstract]:Aim: to investigate whether heptavalent pneumococcal conjugated vaccine PCV7 was included in City Immunization Program (CIP) of Shenzhen City. An empirical study was carried out on the immune and cost effectiveness of vaccination for children under 2 years old in the whole population. Methods: the data of disease burden were collected from the electronic medical records of patients with streptococcus pneumoniae in Shenzhen third Class A Hospital in 2010. The epidemiological data were obtained from the statutory reporting system of Streptococcus pneumoniae of Taiwan Health Insurance Bureau, and the data on vaccine efficacy were obtained from clinical trials published at home and abroad. Finally, according to the decision tree model and demographic data of Shenzhen City, the immunization effect and cost effect after the implementation of the vaccination policy were evaluated. Results: when PCV7 was not included in Shenzhen CIP as the second class vaccine, Because of the lower vaccination rate and higher inoculation price, the cost effect advantage was not available. When PCV7 was introduced into Shenzhen CIP as a kind of vaccine, it was predicted that the 3 1 vaccination strategy of CIP could prevent a total of 36 594 people from suffering from pneumococcal meningitis every year. Streptococcus pneumoniae bacteremia, all caused by pneumonia and otitis media, and 162 deaths were averted. A total of 2,223 life years and 2,004 quality-adjusted life years were obtained. The average cost of obtaining a quality-adjusted life year is 118000 yuan. Conclusion the introduction of CIP into Shenzhen can significantly reduce pneumococcal disease and death in children and adults. It is between 1 and 3 times of per capita GDP in China, which is considered to have the advantage of cost effect.
【作者单位】：北京大学光华管理学院中国卫生经济研究中心;辉瑞中国北京分公司;
【分类号】：R392

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