Health Economic Evaluation For Measles Vaccines Using Decision Tree Markov Model

BackgroundsVaccines are sorts of the quasi-public goods.Vaccinations,which has always been considered one of the most cost-effective public health interventions,not only effectively control or even eliminate diseases,but also avoid the economic loss and social harm caused by illness.The health economics evaluations of vaccines can promote the Expanded Program on Immunization.Moreover,there is not empirical economic evaluations for measles vaccines in China so far as we know.Hence,in this study we estimated the cost-benefit/effectiveness/utility of measles vaccines,taking Zhejiang Province as an example.Meantime,we aim to explore systematic methods of health economic evaluations for vaccines in China and provide reference for other studies.Furthermore,we can give policy recommendations through health economic evaluations of vaccines and thus governments can do rational allocation in terms of scarce health resources to improve the health of whole population.MethodsIn our study,we estimated the costs of vaccine implementing and measles economic disease burden through a multi-stage sampling in Zhejiang Province,and then we used decision-tree Markov model to mimic the infections and deaths decrease of measles owing to vaccination.The birth population in 2014 was set as study cohort,and study range was set as total 40 years.Total costs consist of vaccination implementing costs and vaccine purchase costs.Benefits were defined as reduced economic disease burden.DALYs and QALYs were used as utility parameters.Cost-benefit/effectiveness/utility analysis and sensitivity analysis were used.ResultsThe results showed that total costs of vaccination programs were 16023.70 thousand yuan.When measles direct economic disease burden was put into model,the net benefit was 626.49 million yuan.When measles direct and indirect economic disease burden were put into model,the net benefit was 988.52 million yuan.When measles direct,indirect and invisible economic disease burden were put into model,the net benefit was 1379.68 million yuan.The BCRs were respectively 6.41,6.83,7.06.Total 186534 measles cases and 3404 measles death were avoided based on the simulation.Meanwhile,the CURs were 8153.72(in QALY)and 586.10(in DALY).Measles vaccination rate and protection rate were sensible in the model.ConclusionsMeasles vaccination will not only bring enormous economic and social benefits,but also significantly lower measles infections and deaths.In our study,we conducted a preliminary attempt and exploration of vaccines economic evaluation in China through systematic estimation of vaccine implementing,measles economic disease burden and model simulation,thus we can provide reference to other studies.If more studies on vaccine economic evaluation are launched,it will be of great significance to add newly listed vaccines into the health insurance system and reduce the incidence of population.