Influenza vaccination in acute coronary syndromes patients in Thailand： the cost-effectiveness analysis of the prevention for cardiovascular events and pneumonia

BackgroundInfluenza 种痘临床上被显示了在急性冠的症候群(交流) 减少不利心血管的结果病人，而是经济观点能提供重要数据使决定明智。试图为心血管的事件和生长得很好的肺病 prevention.MethodsLifetime 费用，预期寿命，和调整质量的生活年( QALY )执行终生的年度流行性感冒种痘的经济评估的这研究在上的一个六健康的状态 Markov 模型条件的一个年周期长度以外被估计为交流的一个住院，中风，心失败，肺病，没有住院发生了，或死亡。40-year-old-and-above， 50-year-old-and-above，和 65-year-old-and-above 情形的三年龄组的比较被执行。增长划算比率(ICER ) 和网钱的利益(NMB ) 在 2016 表现为一个社会观点。模型坚韧性被单程、概率的敏感 analyses.ResultsThe 流行性感冒种痘决定在所有年龄组是划算的，由比泰国的可接受的 willingness-to-pay 阀值完全低的主导的 ICER (有更高的有效性的更低的费用)[ 160,000 THB ( 4,466.8 美金)每 QALY ]，与 NMB 的大增长价值。特别，当大多数每年为每 patient.ConclusionsThe 在 129,092 THB (3,603.9 美金) 受益， 50-year-old-and-above 情形被显示出到在交流的标准处理的另外的流行性感冒种痘在所有年龄组是划算的，它应该在临床的实践和健康政策做过程被考虑。

Background Influenza vaccination has been clinically shown to reduce adverse cardiovascular outcomes in acute coronary syndrome （ACS） patients, but the economic perspectives can provide important data to make informed decisions. This study aimed to perform the economic evaluation of lifelong annual influenza vaccination for cardiovascular events and well-established pneumonia prevention. Methods Lifetime costs, life-expectancy, and quality-adjusted live years （QALYs） were estimated beyond one-year cycle length of a six-health states Markov model condition on whether a hospitalization for ACS, stroke, heart failure, pneumonia, no hospitalizations occurred, or death. The comparison of three age-groups of 40-49, 50-65, and 〉 65 years scenario was performed. Incremental cost-effectiveness ratio （ICER） and net monetary benefit （NMB） were presented as a societal perspective in 2016. The model robustness was determined by one-way and prob- abilistic sensitivity analyses. Results The influenza vaccination was cost-effective in all age-groups, by dominant ICERs （lower cost with higher effectiveness） which was completely lower than acceptable willingness-to-pay threshold of Thailand [160,000 THB （4,466.8 USD） per QALYs], with a great incremental value of NMB. Especially, the 50-year-old-and- above scenario was shown as the most benefit at 129,092 THB （3,603.9 USD） for each patient. Conclusions The annually additional influenza vaccination to standard treatment in ACS was cost-effective in all age-groups, which should be considered in clinical practice and health-policy making process.