摘要
目的探讨贵州省实施乙型肝炎（乙肝）疫苗（Hepatitis B vaccine,HepB）免疫策略的成本-效益。方法收集贵州省1996-2016年HepB接种投入、乙肝病毒表面抗原（HBsAg）流行率、慢性乙肝/肝硬化/肝细胞癌（HCC）病例直接医疗费用等数据,估算减少的乙肝病例所致经济损失以及HepB接种成本、净效益和成本效益比（Cost-benefit ratio, CBR）。结果贵州省1999-2016年共接种HepB 25 951 786剂次,减少HBsAg携带者3 195 730例、慢性乙肝319 573例、肝硬化31 957例、HCC 3 196例。2016年慢性乙肝、肝硬化、HCC病例的平均直接医疗费用分别为19 477元、34 321元、49 335元。1999-2016年实施HepB免疫策略总成本为6.75亿元,净效益为42.74亿元,CBR为1∶7.31;1999-2002年、2003-2010年、2011-2016年CBR分别为1∶1.64、1∶16.49和1∶3.17。结论贵州省HepB免疫策略具有良好的成本-效益,特别是2003-2010年HepB纳入免疫规划联合补种免疫策略的CBR极为显著。
Objective To determine the costs and benefits of implementing the hepatitis B vaccine（HepB） immunization strategy in Guizhou province. Methods We obtained data on the cost of HepB immunization, the prevalence of hepatitis B surface antigen（HBsAg）, and the direct medical costs of chronic hepatitis B/liver cirrhosis/hepatocellular carcinoma（HCC） cases during 1996-2016 in Guizhou. We estimated reduction in economic losses from chronic hepatitis, and the cost, the net benefit, and the cost-benefit ratio（CBR） of HepB immunization. Results A total of 25 951 786 doses of HepB were administered during 1996-2016 in Guizhou. HBsAg positivity was prevented among 3 195 730 individuals; 319 573 chronic hepatitis B infections were averted; 31 957 cases of liver cirrhosis were avoided; and 3 196 HCC cases were prevented. The average direct medical costs of chronic hepatitis B, liver cirrhosis, and HCC were 19 477, 34 321, and 49 335 RMB, respectively. The total cost of HepB immunization was 675 million RMB during 1999-2016, with a net benefit of 4.27 billion RMB and a CBR of 1∶7.31. CBRs in 1999-2002, 2003-2010, and 2011-2016 were 1∶1.64, 1∶16.49, and 1∶3.17, respectively. Conclusions Guizhou＇s HepB immunization strategy had a favorable cost-benefit ratio, with a high CBR for the introduction of HepB into the Expanded Program on Immunization combined with supplementary immunization activities during 2003-2010.
作者
张丽
管庆虎
冯军
杨燕妮
田娟
刘铭
赵苏晔
刘淳婷
Zhang Li;Guan Qinghu;Feng Jun;Yang Yanni;Tian Juan;Liu Ming;Zhao Suye;Liu Chunting(Guizhou Provincial Center for Disease Control and Prevention,Guiyang 550004,Guizhou,China;School of Public Health,Guizhou Medical University,Guiyang 550004,Guizhou,China)
出处
《中国疫苗和免疫》
北大核心
2018年第5期539-543,共5页
Chinese Journal of Vaccines and Immunization
