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首页> 外文期刊>Human vaccines & immunotherapeutics. >Cost-effectiveness of the 13-valent pneumococcal conjugate vaccine in adults in Portugal versus 'no vaccination' and versus vaccination with the 23-valent pneumococcal polysaccharide vaccine
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Cost-effectiveness of the 13-valent pneumococcal conjugate vaccine in adults in Portugal versus 'no vaccination' and versus vaccination with the 23-valent pneumococcal polysaccharide vaccine

机译：葡萄牙成年人的13价肺炎球菌缀合物疫苗的成本效果与“无疫苗接种”，与23价肺炎球菌多糖疫苗接种疫苗

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摘要

The burden of pneumococcal disease in adults is substantial from a social and economic point of view. This study assessed the cost-effectiveness of the 13-valent pneumococcal conjugate vaccine (PCV13) for the prevention of invasive pneumococcal disease and pneumococcal pneumonia in adults versus "no vaccination" and versus vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23). A Markov model was used to simulate three strategies: no vaccination, complete vaccination with PPSV23 and complete vaccination with PCV13. The comparison between strategies allowed the estimation of clinical and economic outcomes including incremental cost-effectiveness ratios (ICER) and incremental cost-utility ratios (ICUR). The model took into account the distributions of age, risk profile, vaccination status, type of immunization and time since vaccination in the population. A societal perspective was adopted and a lifetime horizon was considered. Different sources of data and assumptions were used to calibrate PPSV23 and PCV13 effectiveness. Inpatient costs were based on the 2013 diagnosis-related group (DRG) database for National Health Service (NHS) hospitals and expert opinion; NHS official tariffs were the main source for unitary costs. PCV13 shows ICURs of euro17,746/QALY and euro13,146/QALY versus "no vaccination" and vaccination with PPSV23, respectively. Results proved to be robust in univariate sensitivity analyses, where all ratios were below a euro20,000 threshold, with the exception of the scenario with PCV13 effectiveness halved. In a probabilistic sensitivity analysis, 94% of simulations showed cost-effectiveness ratios lower than euro20,000/QALY, in both strategies. It was found that PCV13 is a cost-effective strategy to prevent pneumococcal disease in adults in Portugal.
机译：成人肺炎病虫病的负担与社会和经济的观点相当重要。该研究评估了13价肺炎球菌缀合物疫苗（PCV13）的成本效益，用于预防成人的侵袭性肺炎球菌和肺炎球菌肺炎，与“无疫苗接种”，与23价肺炎球菌多糖疫苗（PPSV23）接种疫苗。 Markov模型用于模拟三种策略：无疫苗接种，用PPSV23完全接种，并用PCV13完全接种疫苗。策略之间的比较允许估计临床和经济结果，包括增量成本效益比率（ICER）和增量成本实用比（ICUR）。该模型考虑了年龄，风险概况，疫苗接种状态，免疫和时间的类型的分布，因为人口中疫苗接种。采用了社会观点，考虑了一生的地平线。使用不同的数据来源和假设来校准PPSV23和PCV13效率。住院费用是基于2013年诊断相关组（DRG）国家卫生服务（NHS）医院和专家意见的数据库; NHS官方关税是统一费用的主要来源。 PCV13显示欧元17,746欧元/ QALY和EURO13,146 / QALY与“无疫苗接种”和PPSV23的疫苗接种。结果证明，在单变量敏感性分析中是强大的，所有比率低于欧洲20,000欧元门槛，除了PCV13有效性减半的情景。在概率的敏感性分析中，在两种策略中，94％的模拟显示成本效益比欧元/ QALY低于欧元/ QALY。发现PCV13是一种经济有效的策略，可防止葡萄牙成人的肺炎球菌病。

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