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首页> 外文期刊>Vaccine >Cost-benefit analysis of hospital based postpartum vaccination with combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap)
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Cost-benefit analysis of hospital based postpartum vaccination with combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap)

机译：结合破伤风类毒素，减少的白喉类毒素和脱细胞百日咳疫苗（Tdap）的结合疫苗的医院产后疫苗的成本效益分析

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Objective: To assess the economic benefits associated with hospital-based postpartum Tdap (combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination.Methods: A decision tree model was constructed to calculate the potential cost-benefit of this strategy from both a health care system and a societal perspective. Probabilities and costs were derived from published literature, data reported to Centers for Disease Control and Prevention, and recommendations from expert panels. The maternal vaccination protection period for infants was defined as 7 months, and 10 years of waning immunity following Tdap for birth mothers was estimated in the model. All cost estimates were inflated to year 2012 US dollars and discounted at a 3% annual discount rate. Results: In the base case from a societal perspective, the expected costs per vaccinated and unvaccinated mother were estimated at $129.27 and $187.97, respectively, suggesting an expected net benefit of $58.70 per vaccinated mother. The overall societal benefits in the cohort of 3.6 million U.S. birth mothers ranged from $52.8-126.8 million, depending on the vaccination coverage level. If including direct medical costs only, the strategy would not generate net savings from a health care system perspective. Annual incidence of pertussis in birth mothers and Tdap efficacy exhibited substantial impact on the model as shown in one-way and two-way sensitivity analyses.Conclusions: Although postpartum Tdap vaccination is not cost-beneficial from a health care system perspective in the base case, this strategy is likely to generate net benefits from a societal perspective.
机译：目的：评估与医院为基础的产后Tdap（破伤风类毒素，减少的白喉类毒素和无细胞百日咳组合疫苗）疫苗接种相关的经济效益。方法：构建决策树模型，从两个方面计算该策略的潜在成本效益卫生保健系统和社会观点。概率和成本来自公开的文献，报告给疾病控制与预防中心的数据以及专家小组的建议。婴儿的孕产妇疫苗接种保护期定义为7个月，并在模型中估计了Tdap后对出生母亲的免疫力下降10年。所有成本估算都升至2012年的美元价格，并按3％的年度折现率折现。结果：从社会的角度来看，每位接种疫苗和未接种疫苗的母亲的预期成本分别为129.27美元和187.97美元，表明每位接种疫苗的母亲的预期净收益为58.70美元。根据疫苗接种的覆盖水平，在360万美国分娩母亲的队列中，整个社会的总收益在52.8-126.8百万美元之间。如果仅包括直接医疗费用，从卫生保健系统的角度来看，该策略将不会产生净节省。如单向和双向敏感性分析所示，出生母亲的百日咳每年发生率和Tdap功效对模型产生了实质性影响。结论：尽管从基本医疗案例来看，从卫生保健系统的角度来看，产后Tdap疫苗接种没有成本效益，从社会角度来看，该策略很可能会产生净收益。

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