本文選題：七價肺炎球菌結(jié)合疫苗　切入點：衛(wèi)生經(jīng)濟學評價　出處：《中國衛(wèi)生經(jīng)濟》2013年04期

【摘要】：目的:基于支付方角度,就七價肺炎球菌結(jié)合疫苗(PCV7)納入深圳市城市免疫規(guī)劃(City Immunization Program,CIP)與否兩種情況,對2歲以下兒童注射疫苗在全人群獲得的免疫效果和成本效果進行實證研究。方法:疾病負擔數(shù)據(jù)取自深圳市三甲醫(yī)院2010年肺炎鏈球菌性疾病患者的電子病歷;流行病學病學數(shù)據(jù)來自臺灣健保局肺炎鏈球菌性疾病法定上報系統(tǒng);疫苗效果數(shù)據(jù)來自國內(nèi)外公開發(fā)表的臨床試驗文獻;最后根據(jù)接種方案及結(jié)果構建的決策樹模型和深圳市人口學數(shù)據(jù)模擬運算,評估實施接種政策后的免疫效果和成本效果。結(jié)果:當PCV7未納入深圳CIP作為二類疫苗使用時,由于較低的接種率和較高的接種價格,結(jié)果不具備成本效果優(yōu)勢;當PCV7納入深圳CIP作為一類疫苗使用時,預測CIP的3+1接種策略每年共可預防36 594人患肺炎鏈球菌性腦膜炎、肺炎鏈球菌性菌血癥、全因肺炎和全因中耳炎,并可避免162人死亡,共獲得2 223個生命年和2 004個質(zhì)量調(diào)整生命年,平均每獲得一個質(zhì)量調(diào)整生命年的成本為11.8萬元。結(jié)論:PCV7納入深圳CIP后,能大幅降低兒童及成人肺炎球菌相關疾病及死亡。根據(jù)WHO對藥物經(jīng)濟學評價的推薦意見,其介于我國1倍至3倍的人均GDP間,認為具有成本效果優(yōu)勢。
[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.
【作者單位】： 北京大學光華管理學院中國衛(wèi)生經(jīng)濟研究中心;輝瑞中國北京分公司;
【分類號】：R392

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