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首页> 外文期刊>Vaccine >Retrospective cost-effectiveness of the 23-valent pneumococcal polysaccharide vaccination program in Australia
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Retrospective cost-effectiveness of the 23-valent pneumococcal polysaccharide vaccination program in Australia

机译：澳大利亚的23价肺炎球菌多糖疫苗接种计划的回顾性成本效益

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BackgroundThe Australian infant pneumococcal vaccination program was funded in 2005 using the 7-valent pneumococcal conjugate vaccine (PCV7) and the 13-valent conjugate vaccine (PCV13) in 2011. The PCV7 and PCV13 programs resulted in herd immunity effects across all age-groups, including older adults. Coincident with the introduction of the PCV7 program in 2005, 23-valent pneumococcal polysaccharide vaccine (PPV23) was funded for all Australian adults aged over 65?years.MethodsA multi-cohort Markov model with a cycle length of one year was developed to retrospectively evaluate the cost-effectiveness of the PPV23 immunisation program from 2005 to 2015. The analysis was performed from the healthcare system perspective with costs and quality-adjusted life years discounted at 5% annually. The incremental cost-effectiveness ratio (ICER) for PPV23 doses provided from 2005 to 2015 was calculated separately for each year when compared to no vaccination. Parameter uncertainty was explored using deterministic and probabilistic sensitivity analysis.ResultsIt was estimated that PPV23 doses given out over the 11-year period from 2005 to 2015 prevented 771 hospitalisations and 99 deaths from invasive pneumococcal disease (IPD). However, the estimated IPD cases and deaths prevented by PPV23 declined by more than 50% over this period (e.g. from 12.9 deaths for doses given out in 2005 to 6.1 in 2015), likely driven by herd effects from infant PCV programs. The estimated ICER over the period 2005 to 2015 was approximately A$224,000/QALY gained compared to no vaccination. When examined per year, the ICER for each individual year worsened from $140,000/QALY in 2005 to $238,000/QALY in 2011 to $286,000/QALY in 2015.ConclusionThe cost-effectiveness of the PPV23 program in older Australians was estimated to have worsened over time. It is unlikely to have been cost-effective, unless PPV23 provided protection against non-invasive pneumococcal pneumonia and/or a low vaccine price was negotiated. A key policy priority should be to review of the future use of PPV23 in Australia, which is likely to be more cost-effective in certain high-risk groups.
机译：背景技术澳大利亚婴儿肺炎球菌疫苗接种计划于2005年使用了2011年使用7价肺炎球菌缀合物疫苗（PCV7）和13价缀合物疫苗（PCV13）.CCV7和PCV13计划导致所有年龄组的畜群免疫效应，包括老年人。在2005年引入PCV7计划的致法巧合，23例肺炎球菌多糖疫苗（PPV23）为所有超过65岁的澳大利亚成年人提供资金。多年来一年的多队员多队员Markov模型是开发回顾性评估的PPV23免疫计划从2005年到2015年的成本效益。分析是从医疗保健系统的角度进行，成本和质量调整后的终身年龄在每年5％折扣。与无疫苗接种相比，每年单独计算从2005年至2015年提供的PPV23剂量的增量成本效率（ICER）。使用确定性和概率敏感性分析探索了参数不确定性。估计估计从2005年到2015年的11年期间发出的PPV23剂量阻止了771个住院治疗和99人死于侵袭性肺炎疾病（IPD）。然而，PPV23预防的估计的IPD病例和死亡率在此期间下降超过50％（例如，从2005年的12.9人死亡，2015年的6.1），可能由婴儿PCV计划的畜群效应驱动。与无疫苗接种相比，2005年至2015年至2015年期间的估计金员约为224,000美元/ Qaly。当每年审查时，每年的ICER在2005年的140,000美元/ QALY中致富于2011年的$ 238,000 / QALY至2015年的$ 286,000 / QALY。结论澳大利亚旧澳大利亚人PPV23计划的成本效益估计随着时间的推移。除非PPV23提供针对非侵入性肺炎球菌肺炎和/或低疫苗价格，否则不太可能具有成本效益。关键政策优先考虑应审查澳大利亚未来使用PPV23，这可能在某些高风险群体中更具成本效益。

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  • 来源
    《Vaccine》 |2018年第42期|共7页
  • 作者

    C. Chen; P. Beutels; J. Wood; R. Menzies; C.R. MacIntyre; P. McIntyre; A.T. Newall;

  • 作者单位

    School of Public Health and Community Medicine University of New South Wales;

    Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID) Vaccine and Infectious Disease Institute University of Antwerp;

    School of Public Health and Community Medicine University of New South Wales;

    School of Public Health and Community Medicine University of New South Wales;

    School of Public Health and Community Medicine University of New South Wales;

    National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS) Kids Research Institute Children’s Hospital at Westmead;

    School of Public Health and Community Medicine University of New South Wales;

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  • 正文语种 other
  • 中图分类 医学免疫学;
  • 关键词

    PPV23; Elderly; Pneumococcal; Economic evaluation; Pneumonia; Adult vaccination;

    机译：ppv23;老年人;肺炎球菌;经济评价;肺炎;成人疫苗接种;

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