Cost-effectiveness of rotavirus vaccination in children under five years of age in 195 countries: A meta-regression analysis.
Cost-effectiveness of rotavirus vaccination in children under five years of age in 195 countries: A meta-regression analysis.
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DOI：
10.1016/j.vaccine.2022.05.042
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发表时间：
2022-06-21
期刊：
影响因子：
5.5
通讯作者：
Weaver, Marcia R.
中科院分区：
文献类型：
--
作者：
Janko, Mark M.;Joffe, Jonah;Michael, Danielle;Earl, Lauren;Rosettie, Katherine L.;Sparks, Gianna W.;Albertson, Samuel B.;Compton, Kelly;Velandia, Paola Pedroza;Stafford, Lauryn;Zheng, Peng;Aravkin, Aleksandr;Kyu, Hmwe H.;Murray, Christopher J. L.;Weaver, Marcia R.
2019年，轮状病毒在5岁以下儿童中造成约151,714人死于腹泻。为了降低死亡率，各国正在考虑将轮状病毒疫苗接种添加到其常规免疫计划中。为这些决策提供信息的成本效益分析(CEA)并不是在每种情况下都可用，而且在它们存在的地方，结果对建模假设很敏感，特别是关于疫苗效力的假设。我们使用Meta回归方法的进展和按地点估计疫苗效力来估计195个国家轮状病毒疫苗接种的增量成本-效果比(ICER)。从塔夫茨大学CEA和全球卫生CEA登记开始，我们使用了截至2017年发表的68篇文章中的515个ICER，提取了938个额外的单向敏感性分析，并从1,418个样本中排除了33个ICER。我们使用五阶段、混合效应的贝叶斯元回归框架来预测ICER，使用Logistic回归模型来预测疫苗节省成本的可能性。对于这两个模型，协变量是疫苗特性，包括效力、研究方法和特定国家的轮状病毒残疾调整寿命(DALY)和人均国内生产总值(GDP)。所有结果均以2017年美元为单位报告。疫苗效力、疫苗成本、人均国内生产总值和轮状病毒DALY是ICERs变异的重要驱动因素。在全球范围内，ICER的中位数为2,289美元(95%不确定区间：147-38,993美元)，范围从中非共和国的每避免DALY(95%UI：13-302美元)85美元到美国的每DALY避免(95%UI：11,030-263,858美元)70,599美元。在有资格获得疫苗联盟GAVI支持的国家中，平均ICER为每避免DALY 255美元(95%UI：39-918美元)，在有资格获得泛美卫生组织循环基金的国家中，ICER平均为每DALY避免2,464美元(95%UI：382-3,118美元)。我们的发现结合了最近的证据，即疫苗效力因地点而异，并支持扩大轮状病毒疫苗接种计划，特别是在有资格获得GAVI(疫苗联盟)支持的国家。
Rotavirus caused an estimated 151,714 deaths from diarrhea among children under 5 in 2019. To reduce mortality, countries are considering adding rotavirus vaccination to their routine immunization program. Cost-effectiveness analyses (CEAs) to inform these decisions are not available in every setting, and where they are, results are sensitive to modeling assumptions, especially about vaccine efficacy. We used advances in meta-regression methods and estimates of vaccine efficacy by location to estimate incremental cost-effectiveness ratios (ICERs) for rotavirus vaccination in 195 countries. Beginning with Tufts University CEA and Global Health CEA registries we used 515 ICERs from 68 articles published through 2017, extracted 938 additional one-way sensitivity analyses, and excluded 33 ICERs for a sample of 1,418. We used a five-stage, mixed-effects, Bayesian metaregression framework to predict ICERs, and logistic regression model to predict the probability that the vaccine was cost-saving. For both models, covariates were vaccine characteristics including efficacy, study methods, and country-specific rotavirus disability-adjusted life-years (DALYs) and gross domestic product (GDP) per capita. All results are reported in 2017 United States dollars. Vaccine efficacy, vaccine cost, GDP per capita and rotavirus DALYs were important drivers of variability in ICERs. Globally, the median ICER was $2,289 (95% uncertainty interval (UI): $147–$38,993) and ranged from $85 per DALY averted (95% UI: $13–$302) in Central African Republic to $70,599 per DALY averted (95% UI: $11,030–$263,858) in the United States. Among countries eligible for support from Gavi, The Vaccine Alliance, the mean ICER was $255 per DALY averted (95% UI: $39–$918), and among countries eligible for the PAHO revolving fund, the mean ICER was $2,464 per DALY averted (95% UI: $382–$3,118). Our findings incorporate recent evidence that vaccine efficacy differs across locations, and support expansion of rotavirus vaccination programs, particularly in countries eligible for support from Gavi, The Vaccine Alliance.
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影响因子：
26.1
作者：
Troeger C;Khalil IA;Rao PC;Cao S;Blacker BF;Ahmed T;Armah G;Bines JE;Brewer TG;Colombara DV;Kang G;Kirkpatrick BD;Kirkwood CD;Mwenda JM;Parashar UD;Petri WA Jr;Riddle MS;Steele AD;Thompson RL;Walson JL;Sanders JW;Mokdad AH;Murray CJL;Hay SI;Reiner RC Jr
通讯作者：
Reiner RC Jr
影响因子：
3.2
作者：
Robinson, Lisa A.;Hammitt, James K.;Resch, Stephen
通讯作者：
Resch, Stephen
DOI：
10.1016/s0140-6736(21)00984-3
发表时间：
2021-08-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2020, Release 1, Vaccine Coverage Collaborators
通讯作者：
GBD 2020, Release 1, Vaccine Coverage Collaborators
影响因子：
11.1
作者：
Marseille E;Larson B;Kazi DS;Kahn JG;Rosen S
通讯作者：
Rosen S
影响因子：
3.7
作者：
Rosettie KL;Joffe JN;Sparks GW;Aravkin A;Chen S;Compton K;Ewald SB;Mathew EB;Michael D;Pedroza Velandia P;Miller-Petrie MB;Stafford L;Zheng P;Weaver MR;Murray CJL
通讯作者：
Murray CJL