全球评估与成人肺炎球菌疾病相关的卫生公用事业:有针对性的文献评论
Min Huang1, Jipan Xie2, Hela Romdhani3
1Merck & Co., Inc., Rahway, NJ, USA. min_huang@merck.com.
肺炎球菌病显著影响生活质量,对成年人的健康效益估计有很大差异. 肺炎球菌疫苗的成本效益分析需要仔细选择效用值,因为数据有限.
科学领域:
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
- 公共卫生 公共卫生
背景情况:
- 肺炎球菌病大大降低了生活质量 (QoL).
- 卫生公用事业对于评估QOL负担和计算质量调整寿命年 (QALYs) 至关重要.
- QALYs为成本效益分析提供信息,评估肺炎球菌疫苗的经济价值.
研究的目的:
- 在北美和欧洲的肺炎球菌疫苗的CUAs中综合使用的实用值.
- 总结关于肺炎球菌疾病和成年人脑膜炎后续症 (PMS) 的全球实用性研究.
主要方法:
- 通过使用 MEDLINE 进行了对 CUAs 的有针对性的文献审查和原始实用性研究.
- 从现有审查中选引用,以确定额外的实用性研究.
- 总结了实用性和不实用性输入,将它们转换为QALY减值,并分析了原始研究估计.
主要成果:
- 确定了65个CUA和25个成年人的原始实用性研究.
- 报告了QALY下降的广泛范围 (例如,0.006-0.8对于未指定的侵入性肺炎球菌病) 和PMS的实用值 (例如,0.319-0.83对于神经缺陷).
- 由于案例定义,偏好权重和地理位置的差异,在实用性估计中观察到相当大的变化.
结论:
- 肺炎球菌病和PMS对成年人造成显著的QoL负担,但实用性估计差异很大.
- 肺炎球菌疫苗的CUA通常使用其他种群/疾病的假设或数据,成人IPD和神经缺陷数据有限.
- 强调需要在经济评估中仔细选择实用值,考虑方法论的稳定性和代表性,并使用灵敏度分析.
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