Health economics of rubella: a systematic review to assess the value of rubella vaccination.
Health economics of rubella: a systematic review to assess the value of rubella vaccination.
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DOI：
10.1186/1471-2458-13-406
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发表时间：
2013-04-29
影响因子：
4.5
通讯作者：
Levin A
中科院分区：
文献类型：
--
作者：
Babigumira JB;Morgan I;Levin A
大多数风疹和先天性风疹综合征（CRS）病例发生在低收入和中等收入国家。世界卫生组织（世卫组织）最近建议各国加快风疹疫苗接种，全球疫苗和免疫联盟目前正在支持大规模麻疹风疹疫苗接种运动。我们对风疹和CRS的卫生经济学评估进行了回顾，以确定证据基础中的差距，并提出未来研究的可能领域，以支持计划中的全球风疹疫苗接种扩展以及消除和根除风疹的努力。我们对在线数据库进行了系统检索，并确定了1970年至2012年期间发表的关于风疹和CRS治疗成本以及风疹疫苗接种成本、成本效益或成本效益的文章。我们回顾了这些研究，并根据进行研究的国家的收入水平、研究设计和回答的研究问题对它们进行分类。我们分析了他们的方法，数据来源和其他细节。我们使用这些数据来确定证据中的差距，并建议未来可能的科学研究领域。我们确定了27项研究：11项成本分析，11项成本效益分析，4项成本效益分析和1项成本效用分析。其中，20项研究在高收入国家进行，5项在中上收入国家，2项在中低收入国家。我们没有发现在低收入国家进行的任何研究。据估计，在中等收入国家，CRS每例每年的费用（按2012年美元计算）在4，200美元至57，000美元之间，在高收入国家，终身费用高达140，000美元。在高收入和中等收入国家，风疹疫苗接种计划，包括卫生工作者、儿童和妇女的疫苗接种，具有良好的成本效益、成本效用或成本效益比。CRS的治疗是昂贵的，风疹疫苗接种计划具有很高的成本效益。然而，为了使研究能够支持风疹疫苗接种的全球推广和消除风疹的努力，需要在低收入国家进行更多的研究，以解决方法上的局限性，并确定提高风疹疫苗覆盖率的最具成本效益的方案战略。
Most cases of rubella and congenital rubella syndrome (CRS) occur in low- and middle-income countries. The World Health Organization (WHO) has recently recommended that countries accelerate the uptake of rubella vaccination and the GAVI Alliance is now supporting large scale measles-rubella vaccination campaigns. We performed a review of health economic evaluations of rubella and CRS to identify gaps in the evidence base and suggest possible areas of future research to support the planned global expansion of rubella vaccination and efforts towards potential rubella elimination and eradication. We performed a systematic search of on-line databases and identified articles published between 1970 and 2012 on costs of rubella and CRS treatment and the costs, cost-effectiveness or cost-benefit of rubella vaccination. We reviewed the studies and categorized them by the income level of the countries in which they were performed, study design, and research question answered. We analyzed their methodology, data sources, and other details. We used these data to identify gaps in the evidence and to suggest possible future areas of scientific study. We identified 27 studies: 11 cost analyses, 11 cost-benefit analyses, 4 cost-effectiveness analyses, and 1 cost-utility analysis. Of these, 20 studies were conducted in high-income countries, 5 in upper-middle income countries and two in lower-middle income countries. We did not find any studies conducted in low-income countries. CRS was estimated to cost (in 2012 US$) between $4,200 and $57,000 per case annually in middle-income countries and up to $140,000 over a lifetime in high-income countries. Rubella vaccination programs, including the vaccination of health workers, children, and women had favorable cost-effectiveness, cost-utility, or cost-benefit ratios in high- and middle-income countries. Treatment of CRS is costly and rubella vaccination programs are highly cost-effective. However, in order for research to support the global expansion of rubella vaccination and the drive towards rubella elimination and eradication, additional studies are required in low-income countries, to tackle methodological limitations, and to determine the most cost-effective programmatic strategies for increased rubella vaccine coverage.
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作者：
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