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Economic evaluation of varicella vaccination in Spain: results from a dynamic model

机译：西班牙水痘疫苗接种的经济评估：动态模型的结果

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Varicella is a universal childhood disease in Spain, causing approximately 400,000 cases, 1,500 hospitalizations and 15 deaths every year. The aim of this study is to determine the economic impact of childhood varicella vaccination on the burden of disease and associated costs by using a dynamic model. The analysis is based on the varicella transmission model developed by Halloran and adapted to the Spanish context. Cost data (Euro, 2004) were derived from previous studies and official tariffs. Two vaccination scenarios were analysed: (1) routine vaccination program for children aged 1-2 years, and (2) routine vaccination program for children aged 1-2 years completed by a catch-up program during the first year of vaccine marketing for children aged 2-11 years. The analysis considers that a similar coverage rate to the MMR one would be achieved (97.15%). A societal perspective, including direct and indirect costs, and a health care payor perspective were adopted. A probabilistic sensitivity analysis was performed. A routine vaccination program has a positive impact on varicella-related morbidity: the number of varicella cases is estimated to be reduced by 89%, and 1230 hospitalizations are prevented. From the societal perspective, scenario (1) is cost-saving whether or not indirect costs are considered (-51 and -4%, respectively). From the Health Care System the strategy is cost-effective, with a cost-effectiveness ratio estimated at 3,982 Euro per life-year gained, although it leads to a small increase in the costs. Considering the impact of vaccination on morbidity and costs, a routine childhood vaccination program against varicella is worth while in Spain without taking into account the potential impact on HZ.
机译：水痘在西班牙是一种普遍的儿童疾病，每年导致约40万例，1,500例住院和15例死亡。本研究的目的是通过动态模型确定儿童水痘疫苗接种对疾病负担和相关费用的经济影响。该分析基于Halloran开发的水痘传播模型，并适应西班牙情况。成本数据（欧洲，2004年）来自先前的研究和官方关税。分析了两种疫苗接种方案：（1）针对1-2岁儿童的常规疫苗接种计划，以及（2）由追赶计划在儿童疫苗营销的第一年完成的针对1-2岁儿童的常规疫苗接种计划年龄2-11岁。分析认为可以实现与MMR相似的覆盖率（97.15％）。采取了包括直接和间接费用在内的社会观点和医疗保健付款人观点。进行了概率敏感性分析。常规的疫苗接种计划对水痘相关的发病率有积极影响：水痘病例数估计减少了89％，并预防了1230例住院。从社会的角度来看，无论是否考虑间接成本（分别为-51％和-4％），方案（1）都是节省成本的。从卫生保健系统开始，该策略具有成本效益，尽管成本效益略有增加，但其成本效益比估计为每生命年3,982欧元。考虑到疫苗接种对发病率和成本的影响，在西班牙值得进行一项常规的儿童水痘疫苗接种计划，而无需考虑对水痘的潜在影响。

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