北京市1992—2013年乙肝疫苗计划免疫对慢性乙型肝炎成本效果评价  

Cost-effectiveness of hepatitis B vaccine immunization program for chronic hepatitis B in Beijing from 1992 to 2013

作　　者：郭艺玮 王宗武 吴疆[3] 吕敏[3] 王溪 白倩 杨勇[1] 李硕 石学峰[1] GUO Yi-wei;WANG Zong-wu;WU Jiang(School of Management,Beijing University of Chinese Medicine,Beijing 100029,China;不详)

机构地区：[1]北京中医药大学管理学院,北京100029 [2]健康报社 [3]北京市疾病预防控制中心

出　　处：《中国公共卫生》2020年第10期1467-1470,共4页Chinese Journal of Public Health

基　　金：北京市科技计划课题(D161100002716005),“北京市乙型肝炎疫苗免疫效果的评估及卫生经济学分析”。

摘　　要：目的对北京市1992—2013年乙型肝炎疫苗免疫策略及措施进行成本–效果分析,为北京市政府优化北京市乙型肝炎防治政策、策略及防控措施提供数据依据。方法以政府的角度对北京市乙肝疫苗免疫策略进行成本效果分析,以接种机构的成本为成本指标,以慢性乙型肝炎发病率为效果指标进行成本效果以及增量成本效果分析。结果北京市1992—2013年由于乙肝疫苗计划免疫的实施,慢性乙肝减少总人数为4403人,总成本为13419.42万元,平均每减少1例慢性乙肝患者成本为30477.90元。乙肝疫苗接种的成本效果比呈现稳步上升趋势,2006年下降到16.79,2013年上升到168.39;增量成本效果比方面,1999—2005年相比1992—1998年,慢性乙肝发病率每多升高1/10万,乙肝疫苗免疫的总成本将增加19.50万元,2006—2013年相比于1999—2005年,慢性乙肝发病率每多上升1/10万,乙肝疫苗免疫的总成本将增长227.75万元。结论北京市1992—2013年实施的乙肝疫苗接种策略具有成本效果。乙肝疫苗接种成本年投入与慢性乙肝效果产出未达到最优组合,仍需加大投入进行改善。Objective To estimate long-term cost-effectiveness of hepatitis B vaccine(HBV)immunization among people born between 1992 and 2013 in Beijing and to provide evidences for policy making and optimizing immunization strategies.Methods Cost-effectiveness and incremental cost-effectiveness ratio were adopted in the study.The cost of HBV immunization was that paid by institutions implementing the immunization and incidence of chronic hepatitis B(CHB)among population in Beijing city was used as effectiveness indicator.Results During the period from 1992 to 2003 in the population of Beijing,the total decreased number of CHB incidents attributed to the HBV immunization was 4403 and the total cost of the HBV immunization was 134194200 yuan;the average cost for one prevented CHB case was 30477.90 yuan.The cost-effectiveness ratio of HBV immunization showed a steady upward trend during the period,with the lowest value of 16.79 in 2006 and the highest of 168.39 in 2013.In terms of incremental cost effect ratio,during 1999–2005,the total cost of HBV immunization would increase by 195000 yuan for every 1/100000 increase in CHB incidence compared with that during 1992–1998;while,during 2006–2013,the total cost of HBV immunization would increase by 2277500 yuan for every 1/100000 increase in CHB incidence compared with that during 1999–2005.Conclusion The HBV immunization implemented in Beijing during 1998–2013 was of cost-effectiveness.However,the cost-effectiveness of HBV immunization does not reach a optimal level,suggesting that the performance of HBV immunization needs to be improved.

关 键 词：北京市 乙肝疫苗 成本效果分析 慢性乙型肝炎 

分 类 号：R186[医药卫生—流行病学]