Preferences for health outcomes associated with Group A Streptococcal disease and vaccination.
Preferences for health outcomes associated with Group A Streptococcal disease and vaccination.
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DOI：
10.1186/1477-7525-8-28
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发表时间：
2010-03-12
影响因子：
3.6
通讯作者：
Hammitt JK
中科院分区：
文献类型：
--
作者：
Lee GM;Salomon JA;Gay C;Hammitt JK
一种26价A组链球菌（GAS）候选疫苗已经开发出来，可以提供对咽炎，侵袭性疾病和风湿热的保护。 然而，使用新疫苗的建议必须考虑到一系列因素，包括父母对不同相关健康结果的偏好。我们的目标是：（1）使用支付意愿（WTP）和时间权衡（TTO）方法描述父母对GAS疾病和疫苗接种的偏好;（2）了解父母对获得的质量调整生命年（QALY）的隐含WTP如何根据所考虑的特定健康结果（例如避免的GAS疾病与疫苗不良事件）而变化。在波士顿市区的2个儿科实践点，对被诊断为GAS咽炎的儿童的父母进行了电话采访。WTP和TTO（用父母的寿命换取孩子的健康）问题，针对2种疫苗和4种疾病相关的健康状态，使用随机选择的开场出价，然后是第二次出价和关于愿意支付或交易的金额的最后一个开放式问题。描述性分析包括WTP和TTO估计值的中位数和四分位数范围。使用Wilcoxon符号秩检验评估疫苗不良事件与疾病状态的WTP/QALY值差异。在119名受访者中，100名（84%）和96名（81%）分别提供了一套完整的WTP和TTO问题的答案。平均支付意愿和贴现避免每种健康状况的TTO值如下：局部反应，$30，0.12天;全身反应，$50，0.22天;脓疱病，$75，1.25天;链球菌性咽喉炎，$75，2.5天;脓毒性关节炎，$1，000，6.6天;和中毒性休克综合征，三千美元，三十一天疫苗不良事件的中位WTP/QALY（约60，000美元/QALY）显著高于疾病状态（18，000至36，000美元/QALY）。与疫苗不良事件相比，父母更倾向于预防儿童GAS疾病。然而，对于预防疫苗不良事件，隐含的WTP/QALY比率更高。对委员会的错误与疏忽的遗憾可能有所不同，疫苗政策制定者应该考虑。
A 26-valent Group A Streptococcus (GAS) vaccine candidate has been developed that may provide protection against pharyngitis, invasive disease and rheumatic fever. However, recommendations for the use of a new vaccine must be informed by a range of considerations, including parents' preferences for different relevant health outcomes. Our objectives were to: (1) describe parent preferences for GAS disease and vaccination using willingness-to-pay (WTP) and time trade-off (TTO) methods; and (2) understand how parents' implied WTP for a quality-adjusted life year (QALY) gained might vary depending on the particular health outcome considered (e.g. averted GAS disease vs. vaccine adverse events). Telephone interviews were conducted with parents of children diagnosed with GAS pharyngitis at 2 pediatric practice sites in the Boston metropolitan area. WTP and TTO (trading parental longevity for child's health) questions for 2 vaccine and 4 disease-associated health states were asked using a randomly selected opening bid, followed by a 2nd bid and a final open-ended question about the amount willing to pay or trade. Descriptive analyses included medians and interquartile ranges for WTP and TTO estimates. The Wilcoxon signed-rank test was used to assess differences in WTP/QALY values for vaccine adverse events vs. disease states. Of 119 respondents, 100 (84%) and 96 (81%) provided a complete set of responses for WTP and TTO questions, respectively. The median WTP and discounted (at 3% per year) TTO values to avoid each health state were as follows: local reaction, $30, 0.12 days; systemic reaction, $50, 0.22 days; impetigo, $75, 1.25 days; strep throat, $75, 2.5 days; septic arthritis, $1,000, 6.6 days; and toxic shock syndrome, $3,000, 31.0 days. The median WTP/QALY was significantly higher for vaccine adverse events (~$60,000/QALY) compared to disease states ($18,000 to $36,000/QALY). Parents strongly prefer to prevent GAS disease in children compared to vaccine adverse events. However, implied WTP/QALY ratios were higher for the prevention of vaccine adverse events. Regret for errors of commission vs. omission may differ and should be considered by vaccine policymakers.
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影响因子：
158.5
作者：
Davies, HD;McGeer, A;Naus, M
通讯作者：
Naus, M
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通讯作者：
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