Cost-Benefit Analysis of a Haemophilus Influenzae Type B Meningitis Prevention Programme in The Philippines
作者:M. Rhona Limcangco、Carol L. Armour、Eugene G. Salole、Susan J. Taylor
DOI:10.2165/00019053-200119040-00006
日期:——
Background: Haemophilus influenzae type b (Hib) meningitis is associated with high mortality and serious sequelae in children under 5 years of age. Vaccines which can prevent this infection are available. Objective: To evaluate the costs and benefits of a 3-dose immunisation schedule in Manila, Philippines. Perspective: Government and societal perspectives. Design and participants: A cost-benefit analysis based on a birth cohort of 100 000 children. The state of health of the cohort with and without a Hib immunisation programme was modelled over a 5-year period. A survey of medical records of patients with Hib in Manila provided data on the extent and cost of sequelae following infection. Intervention: A 3-dose Hib vaccination programme given at ages 2, 3 and 4 months. Results: The model predicted that vaccinating children against Hib meningitis would prevent 553 cases per year in a birth cohort of 100 000, at a cost of 56 200 Philippine pesos (PHP) [$US1605; 1998 exchange rate] per case (base case assumptions of 90% vaccine efficacy rate, 95 per 100 000 Hib incidence rate, 85% vaccination coverage). Results from the cost-benefit analyses indicated that the saving to the government would be around PHP39 million ($US1.11 million), and the saving to society would be PHP255 million ($US7.28 million). Conclusion: There would be a positive economic benefit for the Philippine government and for the Filipino society if a Hib vaccination programme was introduced in Manila.
背景:B 型流感嗜血杆菌(Hib)脑膜炎在 5 岁以下儿童中关联高死亡率和严重后遗症。存在可预防这种感染的疫苗。目标:在菲律宾马尼拉评估三剂接种计划的代价和收益。视角:政府和社会视角。设计和参与者:基于 100,000 名儿童的出生队列进行成本-效益分析。该队列的健康状况在有和没有 Hib 免疫计划的情况下模拟了 5 年的健康状况。一项针对马尼拉 Hib 感染患者的病历调查提供了关于感染后后遗症的严重程度和成本的数据。干预:在 2、3 和 4 个月龄时给予 3 剂 Hib 疫苗接种计划。结果:该模型预测,在 100,000 名出生队列中,预防儿童 Hib 脑膜炎每年将预防 553 例,每例成本为 56,200 菲律宾比索(PHP)[1998 年汇率下为 1,605 美元;基础假设为 90% 疫苗有效率,95/100,000 Hib 发病率,85% 疫苗接种率]。成本-效益分析的结果表明,政府的节约约为 3900 万 PHP(111 万美元),社会的节约约为 25500 万 PHP(728 万美元)。结论:如果在马尼拉引入 Hib 疫苗接种计划,菲律宾政府和菲律宾社会将获得正面的经济收益。