Hum Vaccin Immunother:对香港四价流感疫苗成本效益的决策分析

2015-02-28 范伟译 MedSci原创

目的:三价流感疫苗(TIV)选择了两个有限循环B型流感血统中的一个,而四价流感疫苗(QIV)则包括两个血统。我们从医疗服务提供者和香港社会的视角,研究了四价流感疫苗与三价流感疫苗潜在的成本效益。 方法:在六个年龄组用决策树来模拟四价流感疫苗与三价流感疫苗的效益结果:0-4岁,5-9岁,10-14岁,15-64岁,65-79岁以及≥80岁。由于三价流感疫苗-不匹配的B型流感病毒感染导致单独的直接成

目的:三价流感疫苗(TIV)选择了两个有限循环B型流感血统中的一个,而四价流感疫苗(QIV)则包括两个血统。我们从医疗服务提供者和香港社会的视角,研究了四价流感疫苗与三价流感疫苗潜在的成本效益。

方法:在六个年龄组用决策树来模拟四价流感疫苗与三价流感疫苗的效益结果:0-4岁,5-9岁,10-14岁,15-64岁,65-79岁以及≥80岁。由于三价流感疫苗-不匹配的B型流感病毒感染导致单独的直接成本,直接成本和间接成本,生活质量调整寿命年(QALYs)的损失在各研究组中进行模拟。结果是每个生活质量调整寿命年的成本增加。

结果:在基本情况分析中,四价流感疫苗比三价流感疫苗更有效,在所有年龄人口组中,每个生活质量调整寿命年额外的直接成本和每个生活质量调整寿命年额外的总成本分别为USD 22603和USD 12558。年龄分层分析显示,从供应者的角度来看,在年龄6个月到9岁,大于或者等于80岁四价流感疫苗是有成本效益的;从社会的角度来看,在所有年龄组除了15-64岁,它也是符合成本效益的。流通中三价流感疫苗-不匹配的B型流感的比率和四价流感疫苗额外的成本是关键的影响因子。从医疗服务的提供者和社会的视角来看,四价流感疫苗是优先的选择。

结论:从社会的角度看,香港人群中四价流感疫苗似乎是有成本效益的,除了年龄在15-64岁的人群。从医疗服务提供者的角度来看,在非常年轻的人群(6个月到9岁)和非常老的人群(大于或者等于80岁)中,四价流感疫苗似乎也是有成本效益的。

原始出处

You JH, Ming WK, Chan PK. Cost-effectiveness of Quadrivalent Influenza Vaccine in Hong Kong - A decision analysis. Hum Vaccin Immunother. 2015 Feb 25:0.

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    2015-06-12 kalseyzl
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据最新的Meta分析,一旦患流感就极易发生严重并发症的孕妇患者,大多数医生不推荐其接种流感疫苗。研究者还发现,孕妇对流感疫苗的安全性有所顾虑,更倾向于冒险使她们和胎儿接触病毒。 来自香港大学李嘉诚医学院的Marie Tarrant开展了一项研究,发现医务人员没有向孕妇解释接种流感疫苗的重要性和益处。此外,他们也不给孕妇提供流感疫苗。医务人员的“沉默”告诉孕妇流感疫苗不是非常重要的。 一项研究发