基于决策树-Markov模型的13价肺炎球菌多糖结合疫苗纳入青海省免疫规划成本效益分析  

Cost-benefit analysis of introducing 13-valent pneumococcal polysaccharide conjugate vaccine into the Expanded Program on Immunization of Qinghai province:a decision tree-based Markov cohort model

作　　者：郭子哲 阿克忠 黄崇刚[3] 徐双飞 周慧 梁学耀 巴文生 李晓萍[2] 郝增平[2] 马艳梅[2] 关炳菊[2] 丁睿尧 徐瑾 杜星星 Guo Zizhe;A Kezhong;Huang Chonggang;Xu Shuangfei;Zhou Hui;LiangXueyao;Ba Wensheng;Li Xiaoping;Hao Zengping;Ma Yanmei;Guan Bingju;Ding Ruiyao;Xu Jin;Du Xingxing(Department of Public Health,Faculty of Medicine,Qinghai University,Xining 810001,Qinghai,China;Qinghai Provincial Center for Disease Control and Prevention,Xining 810007,Qinghai,China;Department of Respiration,Qinghai Province Women and Children’s Hospital,Xining 810007,Qinghai,China;School of Public Health,Fudan University,Shanghai 200032,China)

机构地区：[1]青海大学医学部公共卫生系,青海西宁810001 [2]青海省疾病预防控制中心,青海西宁810007 [3]青海省妇女儿童医院呼吸科,青海西宁810007 [4]复旦大学公共卫生学院,上海200032

出　　处：《中国疫苗和免疫》2024年第2期198-204,共7页Chinese Journal of Vaccines and Immunization

摘　　要：目的分析13价肺炎球菌多糖结合疫苗(Pneumococcal polysaccharide conjugate vaccine,PCV13)纳入青海省免疫规划(Expanded Program on Immunization,EPI)的成本效益。方法建立决策树-Markov模型,计算PCV13纳入青海省EPI的2021年出生队列接种成本和肺炎球菌性疾病(Pneumococcal disease,PD)经济负担,与未纳入EPI相比的净效益和效益成本比(Benefit-cost ratio,BCR)。结果PCV13纳入青海省EPI与未纳入EPI相比,PCV13总接种成本将增加12845万元,PD总经济负担将减少12921万元,产生的净效益为76万元,BCR为1.01。具有成本效益的每剂次PCV13最高价格为460元。结论按照当前国产PCV13价格将PCV13纳入青海省EPI从全社会角度略具有成本效益,建议降低疫苗价格以进一步提高成本效益,适时将PCV13纳入青海省EPI。Objective To conduct a cost-benefit analysis of introducing 13-valent pneumococcal polysaccharide conjugate vaccine(PCV13)into the Expanded Program on Immunization(EPI)of Qinghai province.Methods We constructed a decision tree-Markov model to calculate costs of vaccination and economic burden of pneumococcal disease(PD)in the 2021 birth cohort if PCV13 was introduced in the Qinghai EPI and determined net present value and benefit-cost ratio(BCR)compared to not introducing PCV13.Results Compared to not introducing PCV13 in the Qinghai EPI,the total increased vaccination cost of PCV13 introduction would be 128.45 million yuan and the total reduced economic burden of PD(i.e.benefit)would be 129.21 million yuan,yielding a net benefit of 0.76 million yuan and a BCR of 1.01.The maximum cost-beneficial price of PCV13 was 460 yuan per dose.Conclusions From a societal perspective,introducing PCV13 into the Qinghai EPI would be slightly cost-beneficial at the current price of domestic vaccine.We recommend reducing vaccine price to further increase costbenefit and introducing PCV13 into the Qinghai EPI in due course.

关 键 词：13价肺炎球菌多糖结合疫苗 免疫规划 成本效益分析 决策树-Markov模型 

分 类 号：R186[医药卫生—流行病学] R515.9[医药卫生—公共卫生与预防医学]