目的 分析13价肺炎球菌多糖结合疫苗(Pneumococcal polysaccharide conjugate vaccine,PCV13)纳入青海省免疫规划(Expanded Program on Immunization,EPI)的成本效益.方法 建立决策树-Markov模型,计算PCV13纳入青海省EPI的2021年出生队列接种成本和肺炎球菌性疾病(Pneumococcal disease,PD)经济负担,与未纳入EPI相比的净效益和效益成本比(Benefit-cost ratio,BCR).结果 PCV13纳入青海省EPI与未纳入EPI相比,PCV13总接种成本将增加12 845万元,PD总经济负担将减少12 921万元,产生的净效益为76万元,BCR为1.01.具有成本效益的每剂次PCV13最高价格为460元.结论 按照当前国产PCV13价格将PCV13纳入青海省EPI从全社会角度略具有成本效益,建议降低疫苗价格以进一步提高成本效益,适时将PCV13纳入青海省EPI.
Cost-benefit analysis of introducing 13-valent pneumococcal polysaccharide conjugate vaccine into the Expanded Program on Immunization of Qinghai province:a decision tree-based Markov cohort model
Objective To conduct a cost-benefit analysis of introducing 13-valent pneumococcal polysaccharide conjugate vaccine(PCV13)into the Expanded Program on Immunization(EPI)of Qinghai province.Methods We constructed a decision tree-Markov model to calculate costs of vaccination and economic burden of pneumococcal disease(PD)in the 2021 birth cohort if PCV13 was introduced in the Qinghai EPI and determined net present value and benefit-cost ratio(BCR)compared to not introducing PCV13.Results Compared to not introducing PCV13 in the Qinghai EPI,the total increased vaccination cost of PCV13 introduction would be 128.45 million yuan and the total reduced economic burden of PD(i.e.benefit)would be 129.21 million yuan,yielding a net benefit of 0.76 million yuan and a BCR of 1.01.The maximum cost-beneficial price of PCV13 was 460 yuan per dose.Conclusions From a societal perspective,introducing PCV13 into the Qinghai EPI would be slightly cost-beneficial at the current price of domestic vaccine.We recommend reducing vaccine price to further increase cost-benefit and introducing PCV13 into the Qinghai EPI in due course.
13-valent pneumococcal polysaccharide conjugate vaccineExpanded Program on ImmunizationCost-benefit analysisDecision tree-Markov model
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