我国新生儿乙肝疫苗不同免疫策略成本效益分析  

Cost-benefit analysis of high dose and low dose hepatitis B vaccination strategies for infants in China

作　　者：马建新[1] 肖敏[2] 张卫[3] 李倩[1] 庞星火[3] 王怀[3] 王艳红[2] 潘利[2] 李辉[2] 

机构地区：[1]北京市朝阳区疾病预防控制中心流行病和地方病控制科,100021 [2]中国医学科学院基础医学研究所北京协和医学院基础学院流行病学与卫生统计学系 [3]北京市疾病预防控制中心免疫预防所

出　　处：《北京医学》2015年第6期547-550,共4页Beijing Medical Journal

基　　金：艾滋病和病毒性肝炎等重大传染病防治科技重大专项(2012ZX10004904)

摘　　要：目的探讨新生儿高、低剂量乙肝疫苗免疫策略的成本效益。方法以北京市1992年出生新生儿为研究对象,采用成本效益分析方法,对高剂量(10μg×3针)和低剂量(5μg×3针)乙肝疫苗免疫策略的预防效果进行卫生经济学评价。结果实施高剂量免疫策略,可使上述人群急性乙型肝炎、慢性乙型肝炎、肝硬化、肝癌及乙肝表面抗原携带者分别减少1 392、1 445、365、43和3 220例,由此可节省8 046.61万元,效益成本比(BCR)为10.60;低剂量策略对应减少人数为1 233、1 279、323、38和2 851例,节省费用7 123.49万元,BCR为13.16。不同筛查方案、接种率、贴现率、接种成本、筛查率及疫苗保护率不改变上述结果。结论高剂量免疫策略可减少更多的乙肝相关疾病的发生和节省更多的费用,但BCR低于低剂量免疫策略。我国现已推行的高剂量免疫策略可以获得更好的乙肝防控效果。Objective To investigate the cost-benefit of the infant hepatitis B vaccination strategy in China. Methods Cost-benefit analysis was conducted to compare the cost benefit between high-dose （10 μg×3） and low-dose （5 μg×3） vaccination strategies for 1992 birth cohort in Beijing, China. Results Three 10 μg doses of hepatitis B vaccination with 100% coverage could prevent the infection in 1 392, 1 445, 365, 43, and 3 220 individuals with acute hepatitis B, chronic hepatitis B, cirrhosis, primary liver cancer, and HBsAg-carriers, respectively, among 90 776 newborns in 1992, which will result in 80.47 million Yuan saved. The net benefit was 73.53 million Yuan and the benefit cost ratio （BCR） was estimated to be 10.60. Three 5 μg doses of hepatitis B vaccination with 100% coverage could prevent 1 233, 1 279, 323, 38 and 2 851 individuals with acute hepatitis B, chronic hepatitis B, hepatocirrhosis, primary liver cancer, and HBsAg-carriers, respectively, which saved 71.23 million Yuan. The net benefit was 66.20 million Yuan and BCR was 13.16, respectively. Conclusion The high-dose hepatitis B vaccination strategy for infants in Beijing can reduce more diseases related to HBV infection and save more money, although the BCR is lower than low-dose vaccination strategy. The implementation of high-dose vaccination strategy should have better effectiveness in the prevention and control of HBV in China.

关 键 词：乙型肝炎 新生儿 疫苗接种 成本效益分析 

分 类 号：R186[医药卫生—流行病学]