Cost-utility analysis of Japanese encephalitis vaccination among individuals ≥ 15 years of age in Gansu province
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万方数据
维普
目的 评估甘肃省≥ 15岁人群接种乙型脑炎(乙脑)减毒活疫苗(Japanese encephalitis attenuated live vaccine,JEV-L)的成本效用.方法 构建甘肃省和三个乙脑高发市(天水市、平凉市和陇南市)≥15岁人群不接种、接种1剂次、接种2剂次JEV-L策略的决策树-Markov模型,计算相应成本和质量调整生命年(Quality-adjusted life year,QALY),以及接种1剂次和2剂次与不接种相比的增量成本效用比(Incremental cost-utility ratio,ICUR)和增量净货币效益(Incremental net monetary benefit,INMB),并进行敏感性分析.结果 甘肃省≥15岁人群接种1剂次和2剂次JEV-L与不接种相比,ICUR(元/QALY)分别为30 143.9和62 569.8,人均INMB分别为3.2元和-16.0元;天水市、平凉市和陇南市相应ICUR(元/QALY)分别为10 063.1和25 544.2、9 404.6和24 454.2、4 442.5和15 456.7,相应人均INMB分别为30.0元和13.2元、31.7元和15.0元、51.4元和36.4元.单因素敏感性分析显示乙脑发病率、贴现率、年龄别自然死亡率、疫苗价格及接种实施费用对ICUR影响较大.结论 甘肃省≥15岁人群1剂次JEV-L免疫策略以及乙脑高发市1剂次和2剂次JEV-L免疫策略均具有成本效用.
Objective To evaluate the cost-utility of vaccination with Japanese encephalitis attenuated live vaccine(JEV-L)among a population ≥15 years of age in Gansu province.Methods We constructed a decision-tree Markov model of non-,one-,and two-dose JEV-L vaccination strategies among ≥15-year-olds in Gansu province and three prefectures that had high incidences of Japanese encephalitis to determine costs and quality-adjusted life years(QALYs).We calculated incremental cost-utility ratios(ICURs)and incremental net monetary benefits(INMBs)of one-dose and two-dose vaccination strategies compared with non-vaccination and conducted sensitivity analyses.Results ICURs of one-dose and two-dose JEV-L vaccination strategies among≥15-year-olds in Gansu province were 30 143.9 and 62 569.8 yuan per QALY compared with non-vaccination,respectively,with INMBs per person being 3.2 and-16.0 yuan.In the three prefectures,corresponding ICURs(yuan per QALY)were 10 063.1 and 25 544.2;9 404.6 and 24 454.2;and 4 442.5 and 15 456.7,with INMBs(yuan)per person being 30.0 and 13.2;31.7 and 15.0;and 51.4 and 36.4.Univariate sensitivity analysis showed that Japanese encephalitis incidence,discount rate,age-specific natural mortality,and vaccine price/vaccination implementation cost were the most important parameters influencing ICURs.Conclusions A one-dose JEV-L vaccination strategy among≥15-year-olds has good cost-utility in Gansu province;both one-dose and two-dose JEV-L vaccination strategies have good cost-utility in prefectures with high incidences of Japanese encephalitis.
Japanese encephalitisJapanese encephalitis attenuated live vaccineVaccinationCost-utility analysisDecision-tree Markov model
万方数据
维普
