老年人接种23价肺炎球菌多糖疫苗药物经济学研究的系统评价

Study on the Pharmacoeconomics of 23-valent Pneumococcal Polysaccharide Vaccine in Elderly:A Systematic Review

目的：为我国卫生决策部门科学、合理地制定老年人接种23价肺炎球菌多糖疫苗（PPV-23）政策提供理论支持.方法：计算机检索中国期刊全文数据库、万方数据库、Elsevier、PubMed,筛选出老年人接种PPV-23的药物经济学评价的相关文献,分别从成本研究、效果指标、年龄等方面进行统计分析.结果：共纳入13篇文献,合计900 472例老年人,年龄均大于60岁.研究所在地为哥伦比亚、美国、意大利、比利时、荷兰及中国.从成本角度来看,每增加一个生存质量调查年（QALY）成本介于9 239～33 000美元之间;从效果指标来看,成本-效果比介于9 239～45 161美元/AQLY之间.除荷兰一项研究认为65岁以上老年人接种PPV-23不具有成本效益,应该再考虑外,其余研究均显示65岁以上老年人接种PPV-23有一定的成本效益.结论：老年人接种PPV-23具有一定的经济性,且多数国家已将其纳入国家免疫计划.我国现有的研究尚无法确定老年人接种PPV-23的经济性,因此有待开展更多、更高质量的相关研究加以确认.

OBJECTIVE：To provide theoretical support for the scientific and reasonable policy-making of 23-valent pneumococ-cal polysaccharide vaccine（PPV-23）in elderly. METHODS：Retrieved from CJFD,Wanfang Database,Elsevier and PubMed,lit-erature about the pharmacoeconomics evaluation of PPV-23 in elder were selected and statistically analyzed in respects of cost stud-ies,effect indexes and research perspectives. RESULTS：Totally 13 literatures were included,involving 900 472 patients,who were older than 60 years old. Study locations were mainly Colombia,the United States,Italy,Belgium and China. Study results showed,each additional quality-adjusted life-year（QALY）cost was between $ 9 239-$ 33 000 in respect of cost;cost-effectiveness ratio was between $ 9 239-$ 45 161/QALY in respect of effect indexes. Most researches showed PPV-23 in elderly older than 65 years old had certain cast-effectiveness. Only a research in Netherlands held the idea that PPV-23 in elderly was not considered cost-effectiveness.CONCLUSIONS：Putting PPV-23 inelderly has certain cost-effecctiveness and most countries has put it into nation-al immunization program. The present researches can＇t ensure the economy of putting ppv-23 in elderly in china,so it needs more researches with high quality to ensure it.