中国老年人群流感疫苗接种筹资共付机制探索与费用测算

Financing strategies and cost estimates of influenza vaccination for the elderly in China:explore a multi-party co-payment mechanism

流感为我国社会带来了严重的疾病与经济负担,新冠肺炎疫情与流感的叠加风险为流感防控带来了新的挑战。我国老年人群流感相关重症和死亡风险较高、接种疫苗的成本效益较好,且对资金支付更加敏感,应为其设置合理的流感疫苗接种筹资机制,提高疫苗接种率。本文提出了老年人群流感疫苗筹资的三类策略,分别探索在个人-中央财政-地方财政分担机制、中央财政-地方财政分担机制、地方财政支付机制下,老年人群接种成本在个人、中央财政、地方财政之间的分担比例及金额。策略一在短期内对多数地区而言可行性和可持续性较强,策略二有利于进一步提高老年人群接种率,策略三鼓励地方财政支付,帮助缓解中央政府财政压力。从测算结果来看,老年人群每年接种流感疫苗的经济负担较重,推荐采取有急有缓、循序渐进的办法,推动多方共付机制的发展。

The disease burden and economic burden of seasonal influenza is substantial in China,and the Coronavirus disease 2019(COVID-19)pandemic has brought new challenges to the prevention and control of influenza.As a priority group of influenza vaccination,the elderly are at higher risk of influenza-associated severe symptoms and deaths,and they are more price-sensitive vaccine users with better cost-effectiveness of vaccination program.Therefore,a reasonable financing mechanism of influenza vaccination should be designed for the elderly to increase their vaccination rate.This study proposes three financing strategies of influenza vaccination for the elderly in China,trying to explore the distribution of vaccination costs among individuals,central government and local governments under different financing strategies,including the individual-central-local mechanism(strategy 1),the central-local mechanism(strategy 2),and the local payment mechanism(strategy 3).Strategy 1 is feasible and sustainable for most regions in the short term.Strategy 2 is conducive to further increasing the vaccine coverage rate of the elderly.Strategy 3 encourages local fiscal payments to help relieve the financial pressure of the central government.The results revealed a relatively heavy financial burden of influenza vaccination for the elderly,and it is recommended to promote the development of a multiparty co-payment mechanism gradually based on local conditions.