中国1992-2019年乙型肝炎疫苗免疫及母婴阻断策略的成本效益分析  

Cost-benefit analysis of the hepatitis B vaccination to prevent mother-to-child transmission strategies in China,1992-2019

作　　者：郑徽[1] 王富珍[1] 张国民[1] 缪宁[1] 梁晓峰[2] 尹遵栋[1] Zheng Hui;Wang Fuzhen;Zhang Guomin;Miao Ning;Liang Xiaofeng;Yin Zundong(Department of National Immunization Program,Chinese Center for Disease Control and Prevention,Beijing 100050,China;School of Medicine Jinan University,Guangzhou 510632,China)

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]暨南大学基础医学与公共卫生学院,广州510632

出　　处：《中华流行病学杂志》2021年第9期1537-1545,共9页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(11971375);国家科技重大专项(2018ZX10721202)。

摘　　要：目的对我国1992-2019年来实施的乙型肝炎(乙肝)疫苗(HepB)免疫及母婴阻断策略进行卫生经济学评价,为我国乙肝防控策略提供参考。方法构建决策分析马尔科夫模型,对1992-2019年中国出生的新生儿队列进行分析。模型参数主要来自于文献、年鉴、中国CDC。采用单因素敏感性分析验证模型结果的稳定性。结果1992-2019年国家共投入直接成本和社会成本分别约374.30亿元和476.10亿元;有效保护了约5000万人免于成为慢性HBV感染者,减少了1250万人因HBV感染相关疾病而发生的早死;节约乙肝相关疾病治疗的直接医疗负担和社会医疗负担分别约2.89万亿元和6.92万亿元,实现直接净效益2.85万亿元和社会净效益6.87万亿元。1992-2019年我国实施HepB免疫及母婴阻断策略的直接效益成本比为77.21,社会效益成本比为145.29。结论1992-2019年我国实施的HepB免疫及母婴阻断策略具有成本-效益收益。Objective To make a cost-benefit analysis of the hepatitis B vaccination(HepB)to prevent mother-to-child transmission(PMTCT)strategies in China,1992-2019.Methods We built a decision analytic-Markov model to estimate the birth cohorts of 1992-2019.The parameters in our model were referred from literature,published yearbooks,and data from Chinese Center for Disease Control and Prevention.We conducted a univariate sensitivity analysis to test the robustness of the model.Results For the 28 birth cohorts,the Chinese government has invested 37.43 billion RMB Yuan in direct costs and 47.61 billion RMB Yuan in societal costs on HepB vaccination and HBV prevention of mother to child transmission(PMTCT).And we estimated that about 50 million chronic HBV infections and 12.5 million premature deaths due to HBV-related diseases would be averted.China would save 2.89 trillion RMB Yuan and 6.92 trillion RMB Yuan for the direct and societal medical burden on HBV-related conditions.The direct and societal net benefit was 2.85 trillion RMB yuan 6.87 trillion RMB yuan,respectively.The direct and societal benefit-cost ratios(BCRs)were 77.21 and 145.29,respectively.Conclusion The strategies of HepB vaccination for HBV PMTCT prevention were cost-effective in China during 1992-2019.

关 键 词：乙型肝炎 疫苗免疫 母婴阻断 成本效益分析 

分 类 号：R512.62[医药卫生—内科学]