贵州省实施乙型肝炎疫苗免疫策略的成本-效果分析  

Cost-effectiveness analysis on the immunization strategy of hepatitis B vaccine,Guizhou

作　　者：张丽[1] 冯军[1] 管庆虎[1] 刘铭[1] 赵苏晔[1] 刘淳婷[1] ZHANG Li;FENG Jun;GUAN Qing-hu;LIU Ming;ZHAO Su-ye;LIU Chun-ting(Guizhou Provincial Center for Disease Control and Prevention,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550004

出　　处：《现代预防医学》2018年第17期3147-3150,3172,共5页Modern Preventive Medicine

摘　　要：目的分析贵州省实施乙型肝炎疫苗(Hepatitis B vaccine,Hep B)免疫策略的成本-效果。方法根据贵州省Hep B接种情况,1992年、2006年、2014年贵州省乙肝血清流行病学调查结果,计算全省不同时期Hep B接种投入以及接种Hep B的成本效果比值(Cost-Effectiveness Ratio,CER)。结果贵州省1999-2016年共接种Hep B 25 951 786剂次。全省推广使用Hep B、纳入免疫规划并联合查漏补种免疫策略18年,共减少HBs Ag携带者3 195 730例,减少慢性乙肝319 573例,减少肝硬化31 957例,减少肝癌3 196例。1999-2016年贵州省实施Hep B免疫策略总投入成本6.75亿元,18年间接种Hep B每减少1例HBs Ag携带者、慢性乙肝、肝硬化及肝癌病例需投入的成本为190.13元,其中,推广使用Hep B疫苗时期(1999-2002年)、纳入免疫规划并联合Hep B查漏补种时期(2003-2010年)以及后Hep B常规免疫时期(2011-2016年)接种Hep B每减少1例HBs Ag携带者、慢性乙肝、肝硬化及肝癌病例需投入的成本分别为579.79元、78.09元和359.12元。结论接种Hep B对降低贵州省接种人群乙肝发病水平具有良好的成本-效果,2003-2010年将Hep B纳入免疫规划并联合查漏补种免疫策略的成本效果最好。Objective To analyze the cost-effectiveness of implementing the immunization strategy of hepatitis B vaccine（ HepB） during the different periods in Guizhou Province. Methods According to the results of HepB vaccination and sero-epidemiological survey in 1992,2006 and 2014,the cost-effectiveness ratio（ CER） of HepB was counted during the different periods in Guizhou Province. Results It was estimated that the total amount of HepB was 25. 95 million from 1999 to 2016. 3.20 million HBsAg carriers,320 thousand chronic hepatitis B,32 thousand cirrhosis and 3 196 hepatocellular carcinoma cases could be decreased by popularizing and implementing the routine immunization and supplementary of HepB. The total cost of hepatitis B immunization was estimated to be 675 million RMB,meanwhile,the average cost of reducing one case of HBsAg carrier,chronic hepatitis B,liver cirrhosis and liver cancer was 190. 13 yuan. It could be divided into 3 stages： stage A（ 1999-2002,HepB popularized）,stage B（ 2003-2010,the EPI and supplementary immunization were implemented） and stage C（ 2011-2016,post-EPI period for HepB）,among which the average cost to reduce one case of HBsAg carrier,chronic hepatitis B,liver cirrhosis and liver cancer was 579. 79 yuan,78. 09 yuan and 359. 12 yuan,respectively. Conclusion These results show that the current cost-effectiveness of hepatitis B vaccination is pretty good,and the CER of the strategy on EPI and supplementary immunization is the best from 2003 to 2010.

关 键 词：乙型病毒性肝炎疫苗 成本-效果 

分 类 号：R186[医药卫生—流行病学]