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首页> 外文期刊>Vaccine >Epidemiological impact and cost-effectiveness of introducing vaccination against serogroup B meningococcal disease in France
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Epidemiological impact and cost-effectiveness of introducing vaccination against serogroup B meningococcal disease in France

机译：对法国血群B脑膜炎疾病引入疫苗接种的流行病学影响及成本效益

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Introduction: Despite its low incidence in France, invasive serogroup B meningococcal disease remains a public health concern. A new vaccine against the disease, Bexsero (R), has been licensed in the EU. We studied the epidemiological impact and cost-effectiveness of routine vaccination using Bexsero (R) in order to inform the decision-making process regarding its potential inclusion in the vaccination schedule. Methods: A multi-generational Markov model was used. Time horizon was set to 100 years. Five vaccination strategies were evaluated: infants at 3, 5, 6 and 13 months, toddlers at 13,15 and 27 months and adolescents at 15 years provided 2 doses one month apart. A booster dose at 15 years old and a catch-up for 15 years old subjects during the first 15 years of the programme were added to the infant and toddler strategies. Costs per QALY gained were computed from a restricted societal perspective including direct costs only. Herd immunity was simulated in an alternative base-case scenario and sensitivity analyses. Results: In the base-case analysis without herd immunity and with all cohorts vaccinated, at 40 per vaccine dose, routine infant vaccination would provide the lowest cost per QALY gained ((sic)380,973) despite only preventing 18% of cases. Under the assumption of herd immunity, the adolescent vaccination would provide the lowest cost per QALY gained ((sic)135,902) preventing 24% of cases. Infant vaccination with a late booster and catch-up would prevent 51% of cases with a cost of (sic)188,511 per QALY gained. Conclusions: Given current meningococcal epidemiology in France and the available data on the protection provided by Bexsero (R), our modelling work showed that routine vaccination against serogroup B meningococcal disease is not cost-effective. (C) 2016 Elsevier Ltd. All rights reserved.
机译：介绍：尽管在法国发病率低，但侵袭性血清群B脑膜炎疾病仍然是公共卫生问题。对疾病的新疫苗Bexsero（R），已在欧盟获得许可。我们使用Bexsero（R）研究了常规疫苗接种的流行病学影响和成本效益，以便在疫苗接种时间表中通知决策过程。方法：使用多世代马尔可夫模型。时间地平线设定为100年。评估了五种疫苗接种策略：婴儿3,5,6和13个月，幼儿在13,15和27个月和27个月和青少年，每月2个月分开。在该计划的前15年期间，15岁的增压剂量和15岁的主题被添加到婴儿和蹒跚学步的策略中。从限制的社会角度计算每个QALY获得的成本，包括直接成本。在替代的基本情况场景和敏感性分析中模拟了畜群免疫力。结果：在没有畜群免疫的基本情况分析和接种疫苗的所有群体，每疫苗剂量为40个，常规婴儿疫苗接种可提供每种脑（（SiC）380,973）的最低成本，尽管只预防18％的病例，但只有18％的病例。在畜群免疫力的假设下，青少年疫苗接种将提供每种脑（（SiC）135,902）的最低成本，预防24％的病例。婴儿疫苗接种具有晚期助推器和追赶，可以预防51％的案例，每次QALY的成本为188,511。结论：根据Bexsero（r）提供的法国目前脑膜炎球菌流行病学以及关于Bexsero（R）提供的可用数据，我们的建模工作表明，针对血清群体B脑膜炎疾病的常规疫苗接种并不具有成本效益。 （c）2016 Elsevier有限公司保留所有权利。

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