■美国食品和药物管理局批准了20价肺炎球菌结合疫苗(PCV20)以预防肺炎球菌疾病。在常规PCV20疫苗接种的背景下,我们评估了PCV20追赶计划的成本效益,公共卫生和经济影响,并估计了抗生素处方数量和避免的抗生素耐药性感染.
■以人口为基础,多队列,决策分析马尔可夫模型是使用与以前的PCV20成本效益分析一致的参数开发的。在干预臂中,此前已完成PCV13疫苗接种的14~59个月儿童接受了PCV20的补充剂量.在比较器臂中,未给予追赶PCV20剂量。疫苗接种的直接和间接好处在10年的时间范围内被捕获。
■PCV20追赶计划将预防5,469例侵袭性肺炎球菌疾病病例,50,286例住院肺炎病例,218,240例门诊肺炎病例,582,302例中耳炎,1800人死亡,代表30,014个生命年和55,583个质量调整生命年的净收益。此外,将避免720,938种抗生素处方和256,889种抗生素耐药性感染。追赶计划将节省8亿美元的成本。这些结果对敏感性和情景分析是稳健的。
■PCV20追赶计划可以预防肺炎球菌感染,抗生素处方和抗菌素耐药感染,在美国将节省成本。
UNASSIGNED: The US Food and Drug Administration approved the 20-valent pneumococcal conjugate vaccine (PCV20) to prevent pneumococcal disease. In the context of routine PCV20 vaccination, we evaluated the cost-effectiveness and public health and economic impact of a PCV20 catch-up program and estimated the number of antibiotic prescriptions and antibiotic-resistant infections averted.
UNASSIGNED: A population-based, multi-cohort, decision-analytic Markov model was developed using parameters consistent with previous PCV20 cost-effectiveness analyses. In the intervention arm, children aged 14-59 months who previously completed PCV13 vaccination received a supplemental dose of PCV20. In the comparator arm, no catch-up PCV20 dose was given. The direct and indirect benefits of vaccination were captured over a 10-year time horizon.
UNASSIGNED: A PCV20 catch-up program would prevent 5,469 invasive pneumococcal disease cases, 50,286 hospitalized pneumonia cases, 218,240 outpatient pneumonia cases, 582,302 otitis media cases, and 1,800 deaths, representing a net gain of 30,014 life years and 55,583 quality-adjusted life years. Furthermore, 720,938 antibiotic prescriptions and 256,889 antibiotic-resistant infections would be averted. A catch-up program would result in cost savings of $800 million. These results were robust to sensitivity and scenario analyses.
UNASSIGNED: A PCV20 catch-up program could prevent pneumococcal infections, antibiotic prescriptions, and antimicrobial-resistant infections and would be cost-saving in the US.