| 肠道病毒71型灭活疫苗的卫生经济学评价:包括手足口病后遗症损失 |
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| 引用本文： | 常文龄,陈婷婷,杨春霞.肠道病毒71型灭活疫苗的卫生经济学评价:包括手足口病后遗症损失[J].现代预防医学,2022,0(19):3609-3614. |
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| 作者姓名： | 常文龄 陈婷婷 杨春霞 |
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| 作者单位： | 四川大学华西公共卫生学院/四川大学华西第四医院，流行病与卫生统计学系，四川 成都 610041 |
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| 摘 要： | 目的 结合手足口病后遗症造成的经济损失与健康寿命损失，评估EV71疫苗接种的流行病学效果与成本效益。方法 构建Markov模型，采用成本效益分析，比较1 500万新生儿在30%覆盖率接种与不接种疫苗两种策略下的临床事件与经济学结果，模型参数来源于公开数据库或已发布数据。结果 1 500万新生儿接种EV71疫苗（覆盖率30%）可以避免1 210 434例手足口病发病，4 757例重型，242例后遗症以及72例死亡，挽救38 762.94个质量调整寿命年（QALYs）。成本仅包括疫苗接种成本与手足口病疾病负担时，增量成本效益比（ICER）为27 792.01元/QALY。成本包括后遗症经济损失时，疫苗接种人均净效益为396.70元。敏感性分析提示，疫苗价格阈值为397.05元每剂。结论 接种EV71疫苗能减少手足口病临床事件发生，具有成本效益，有利于改善手足口病疾病现状，降低疾病负担。
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| 关 键 词： | EV71疫苗 手足口病 经济学 医学 成本-效益 |
Health economics evaluation on enterovirus 71 inactivated vaccine: including the sequelae loss of hand-foot-mouth disease |
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| CHANG Wen-ling,CHEN Ting-ting,YANG Chun-xia.Health economics evaluation on enterovirus 71 inactivated vaccine: including the sequelae loss of hand-foot-mouth disease[J].Modern Preventive Medicine,2022,0(19):3609-3614. |
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| Authors: | CHANG Wen-ling CHEN Ting-ting YANG Chun-xia |
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| Affiliation: | West China School of Public Health and West China School of Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China |
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| Abstract: | Objective To evaluate the public health impact and cost-effectiveness of EV71 vaccination in China, with the consideration of the economic and healthy life year lost caused by hand-foot-mouth disease sequelae based on the actual vaccination situation. Methods A Markov model was constructed, and cost-benefit analysis and threshold analysis were used to compare clinical events and economic outcomes among 15 million neonates under two strategies (Vaccinate EV71 vaccine at 30% coverage and no vaccination). Model parameters were from public databases or published data. Results In the base case, 15 million neonatal cohorts were vaccinated with EV71 vaccine (30% coverage, 168 yuan per dose), which could avert 1,210,434 hand-foot-mouth disease (HFMD) cases, 4,757 severe HFMD cases, 242 HFMD sequelae cases, and 72 deaths, saving 38,762.94 quality-adjusted life-years (QALYs). When the cost only included vaccination cost and HFMD disease burden, the incremental cost-effectiveness ratio (ICER) was 27,792.01 yuan/QALY. When the cost included economy lost caused by sequelae, the net benefit of vaccination was 396.70 yuan. Sensitivity analysis suggested that in order to ensure the cost-effectiveness of EV71 vaccination, the vaccine price threshold was 397.05 yuan per dose. Conclusion EV71 vaccination can reduce the incidence, severity and death of HFMD and is cost-effective. It helps to improve the status of HFMD and decreases related disease burden. |
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| Keywords: | EV71 vaccine Hand-foot and mouth disease Economics Medicine Cost-effectiveness |
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