The Cost-benefit Analysis Of Measles' Vaccination

Objective:Although the incidence of measles decreased rapidly as mass vaccination campaign was conducted,the epidemic situation still austerity:the morbidity kept on high level,seasonal distribution was broken,and severe adverse reaction occurred occasionally.So,whether the measles vaccination could effectively control or eliminate the epidemic situation at present and whether the cost-effectiveness ratio was economical or reasonable attracted experts' and leaders' earnest attention.In order to control the measles more effectively and to evaluate the health economics indexes, this research was conducted.Method:Counties' Centre of Disease Prevention and 3 inoculation units randomly selected from each county were recruited as subjects.Total eight items including utilization cost of vaccine and depreciation of Cold Chain Conditions in 2006 were investigated.And our survey included all seven vaccine varieties of the national and provincial Immune Programming.Treatment costs, accompanying miss-work losses,and daily traffic costs of 321 cases, which covered all the incidence measles cases in Hangzhou in 2006, except some survey defaulting cases,were investigated.The effectiveness of primary immunization of measles vaccine on eight-month-children for 15 years in succession were also analyzed, and results of other similar studies on HI detection of Hemagglutination Inhibition antibody level before and after primary immunization were cited,too.The correlation between pre- and post-immunization antibody titer,and correlation between pre-immunization antibody titer and positive conservation rate and post-immunization protection rate were all analyzed.In order to assess short-term effects after immunization,curve fitting were adopted in analyzing the relationship between post-immunization antibody titer and the growth multiples of antibody titer.Exponential smoothing method,reduction of susceptible group method,and median act were used to predict the incidence of measles and calculate the number of cases reduced,basing on the information of 1950~2006 measles epidemic in Hangzhou.The value created by avoiding delays chaperoned or death was analyzed on the base of GNP,per capita national income,and per capita consumption expenditure of urban and rural residents,all of which were announced by The National Bureau of Statistics.Results:According to the results of cost and benefit comparison,in 2006,the vaccination costs was 6132091RMB,including 431925RMB vaccine costs,and the accompanying miss-work losses was 3527437RMB.As the 15 years' consecutive monitoring data on immune effect of 1027 pairs were summarized,the percentage of whoes protection level reached 1:2 one month after immunization was 93.48%, while that reported by other similar studies was 96.60%.After digital conversion of the pre-immunization antibody titer,Log10(the pre-immunization antibody titer)was represented by X,and the ratio of pre- and post-immunization antibody titer by Z.Following these, Linear Equations,Logarithmic Equation,Geometric Series Curve Model, and Index Equation were established,and a relatively ideal Goodness-of-fit with statistical significance was drawn(the Index Equation:Z=14.1087X-0.8837).To estimate the reduced cases per year after measles vaccination,different methods were adopted:the result of Simple Method was 17002.70 cases reduced per year,while that of Holt Method was 9337.59.5090 reduction was estimated on incidence number by Susceptible Population Reduction Method.As the median incidence of 1951~1983,duringwhich large-scale measles immunization per monthwas not conducted yet,was 25.04/100 000,we could calculated that in the following 23 years,13357 cases were reduced every year.According to this survey,the total cost of all direct economic benefits was 13045340 RMB including the direct cost of treatment was 9482670 RMB,accompanying miss-work losses 2861609.2 RMB,raising fees losses 6920 RMB,and transport cost during the treatment 694141 RMB.While according to the survey of treatment cost,the indirect economic benefits was 12020460 RMB including 6751950 RMB from avoiding accompanying miss-work loss and 5268510 RMB from reducing deaths.Over all,the net benefits were equivalent to the sum of direct and indirect economic benefits minus cost,and the cost-benefit ratio was equivalent to cost divided by total benefits.Conclusions:It can still bring ideal health economics efficiency to conduct measles vaccbine immunication at present.