肺炎球菌疫苗接种和增加美国老年人接种疫苗的计划成本效益的变化
Angela R Wateska1, Mary Patricia Nowalk1, Shoroq M Altawalbeh1,2
1Departments of Medicine and Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Journal of the American Geriatrics Society
|June 1, 2024
概括
由于各种因素,促进老年人肺炎球菌疫苗接种的计划可能不具有成本效益. 目前美国对成人肺炎球菌疫苗的建议不太可能在经济上有利.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 诸如不那么复杂的成人肺炎球菌疫苗推,儿童疫苗接种的间接影响和疫苗犹等因素可能会降低成人疫苗接种计划的成本效益.
- 以前的分析表明,这些计划在经济上有利.
研究的目的:
- 评估目前美国针对老年人的肺炎球菌疫苗接种策略的成本效益,有或没有吸收增强计划.
- 为了比较不同的疫苗接种计划,包括单独使用20价值肺炎球菌合疫苗 (PCV20) 和15价值肺炎球菌合疫苗加上23价值肺炎球菌多糖体疫苗 (PCV15/PPSV23).
主要方法:
- 一个马尔科夫模型被用来比较黑人和非黑人65岁的队伍的疫苗接种策略与不接种疫苗.
- 该模型结合了流行病前的疾病风险,疾病/疫苗成本和疫苗的有效性,从医疗保健的角度分析了一生的时间,每年有3%的折扣.
主要成果:
- 吸收计划减少了整体肺炎球菌疾病. 然而,在黑人队伍中,PCV20没有计划的成本为每QALY216,805美元. 在非黑人群体中,所有策略都超过了20万美元/QALY.
- 儿童疫苗接种的间接影响和使用更简单的策略增加疫苗接种减少了经济有利性. 概率敏感性分析表明,当前的建议在<20万美元/QALY值下不太可能得到支持.
结论:
- 目前美国对老年人的肺炎球菌疫苗接种建议似乎在经济上是不合理的,即使有提高接种率的计划.
- 开发针对成人疾病中普遍存在的血清型的替代性肺炎球菌疫苗是有必要的.
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