The cost-effectiveness of varicella vaccination in Canada

被引:77
作者
Brisson, M
Edmunds, WJ
机构
[1] Publ Hlth Lab Serv, Ctr Communicable Dis Surveillance, Immunisat Div, London NW9 5EQ, England
[2] City Univ London, Dept Econ, London EC1V 3HB, England
基金
英国医学研究理事会;
关键词
varicella vaccine; VZV; zoster; economic analysis; cost-effectiveness; mathematical-modeling;
D O I
10.1016/S0264-410X(01)00437-6
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A deterministic realistic age-structured model was used to predict the impact of vaccination on the incidence of varicella and zoster. Unit costs, estimated from literature, were applied to the predicted health outcomes. Various vaccination programs were investigated and a sensitivity analysis was performed. Assuming no impact of vaccination on zoster, varicella vaccination is estimated to cost $45,000, 51,000 and 18,000 per life-year gained from the health payer's perspective for infant, infant with catch-up campaign, and preteen programs, respectively. From the societal perspective, mass infant varicella vaccination was estimated to be highly cost saving in Canada. Importantly, infant varicella vaccination could result in a short- to medium-term increase of zoster incidence and thus cause vaccination to be highly cost-ineffective ($118,000 per life-year gained) under the health payer's perspective, From a health payer's perspective the preteen vaccination is the only strategy that is deemed cost-effective. The cost-effectiveness of infant vaccination rests heavily on the unknown relationship between varicella and zoster. (C) 2002 Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:1113 / 1125
页数:13
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