机构:[1]Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China临床科室职能科室呼吸科临床流行病与循证医学中心首都医科大学附属北京儿童医院[2]Pfizer Inc. New York, NY, United States of America[3]Pfizer Inc., Beijing, China[4]Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, National Clinical Research Centre for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Laboratory of Microbiology, Beijing Children's Hospital, Beijing Pediatric Research Institute, Capital Medical University, Beijing, China,科研平台呼吸疾病研究室儿科研究所首都医科大学附属北京儿童医院[5]Elysia Group, LLC., New York, NY, United States of America[6]Pfizer Inc. Collegeville, PA, United States of America
Background The burden of pneumococcal disease in China is high, and a 13-valent pneumococcal conjugate vaccine (PCV13) recently received regulatory approval and is available to Chinese infants. PCV13 protects against the most prevalent serotypes causing invasive pneumococcal disease (IPD) in China, but will not provide full societal benefits until made broadly available through a national immunization program (NIP). Objective To estimate clinical and economic benefits of introducing PCV13 into a NIP in China using local cost estimates and accounting for variability in vaccine uptake and indirect (herd protection) effects. Methods We developed a population model to estimate the effect of PCV13 introduction in China. Modeled health states included meningitis, bacteremia, pneumonia (PNE), acute otitis media, death and sequelae, and no disease. Direct healthcare costs and disease incidence data for IPD and PNE were derived from the China Health Insurance and Research Association database; all other parameters were derived from published literature. We estimated total disease cases and associated costs, quality-adjusted life years (QALYs), and deaths for three scenarios from a Chinese Payer Perspective: (1) direct effects only, (2) direct+indirect effects for IPD only, and (3) direct+indirect effects for IPD and inpatient PNE. Results Scenario (1) resulted in 370.3 thousand QALYs gained and 12.8 thousand deaths avoided versus no vaccination. In scenarios (2) and (3), the PCV13 NIP gained 383.2 thousand and 3,580 thousand QALYs, and avoided 13.1 thousand and 147.5 thousand deaths versus no vaccination, respectively. In all three scenarios, the vaccination cost was offset by cost reductions from prevented disease yielding net costs of (sic)29,362.32 million, (sic)29,334.29 million, and (sic)13,524.72 million, respectively. All resulting incremental cost-effectiveness ratios fell below a 2x China GDP cost-effectiveness threshold across a range of potential vaccine prices. Discussion Initiation of a PCV13 NIP in China incurs large upfront costs but is good value for money, and is likely to prevent substantial cases of disease among children and non-vaccinated individuals.
第一作者机构:[1]Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
通讯作者:
通讯机构:[2]Pfizer Inc. New York, NY, United States of America
推荐引用方式(GB/T 7714):
Shen Kunling,Wasserman Matthew,Liu Dongdong,et al.Estimating the cost-effectiveness of an infant 13-valent pneumococcal conjugate vaccine national immunization program in China[J].PLOS ONE.2018,13(7):-.doi:10.1371/journal.pone.0201245.
APA:
Shen, Kunling,Wasserman, Matthew,Liu, Dongdong,Yang, Yong-Hong,Yang, Junfeng...&Farkouh, Raymond.(2018).Estimating the cost-effectiveness of an infant 13-valent pneumococcal conjugate vaccine national immunization program in China.PLOS ONE,13,(7)
MLA:
Shen, Kunling,et al."Estimating the cost-effectiveness of an infant 13-valent pneumococcal conjugate vaccine national immunization program in China".PLOS ONE 13..7(2018):-