我国粤港澳大湾区流感疫苗经济学评价的系统分析

Systematic review of the economic evaluation of influenza vaccines in the Guangdong-Hong Kong-Macao Greater Bay Area

目的系统分析我国粤港澳大湾区流感疫苗卫生经济学评价的研究现状,为今后学者开展粤港澳大湾区流感疫苗经济性评价提供方法学参考。方法计算机检索PubMed、Embase等7个英文数据库和中国知网、万方数据等3个中文数据库,收集研究地区为粤港澳大湾区的流感疫苗卫生经济学评价研究,检索时限为建库起至2022年6月30日。筛选文献、提取信息后,对纳入文献的研究设计、评价方法、模型情况、经济学评价结果与结论进行描述性分析,并采用卫生经济研究质量评价工具对文献质量进行评价。结果共纳入12篇文献,其中7篇的研究地区为中国香港,6篇的目标群体为老年群体,5篇的研究角度为全社会角度,研究时限从6个月到9年不等。有8篇文献采用了成本-效用分析法,仅有2篇使用了传染病模型。有8篇文献进行了敏感性分析,且大部分文献同时进行了单因素敏感性分析和概率敏感性分析。有10篇文献的评价结果表明,(联合)接种疫苗或提高疫苗接种率的方案更具经济性。12篇文献中,有4篇的质量评分>75分,属于高质量研究。结论尽管大部分的纳入研究都显示接种疫苗具有经济性,但现有文献的质量有待提升。建议后续开展大湾区流感疫苗经济学评价时,可考虑增加针对我国澳门地区和广东省其他城市的经济学评价,优先选用动态模型和本地居民的近期数据,并参考相关工具、指南,以提高研究设计的规范性和科学性。

OBJECTIVE To systematically analyze the status of health economic evaluation studies of influenza vaccination in Guangdong-Hong Kong-Macao Greater Bay Area(GBA)of China,and to provide a methodological reference for future scholars to carry out economic evaluations of influenza vaccine in GBA.METHODS Seven English databases such as PubMed and Embase and three Chinese databases such as CNKI and Wanfang database were searched.The economic evaluation studies of influenza vaccines with the study area of GBA were collected.The search time frame was from the inception to June 30,2022.After screening the literature and extracting key information,descriptive analysis was conducted on the study design,evaluation methods,model settings,results and conclusions of these collected papers,and the quality of the papers was evaluated using Quality of Health Economic Studies.RESULTS A total of 12 papers were included,of which 7 had a study region of Hong Kong in China,6 had an older target group,5 had a society-wide perspective,and the study time frame ranged from 6 months to 9 years.Besides,8 papers used cost-utility analysis,only 2 used an epidemic model;8 papers conducted sensitivity analyses,and most of them conducted both one-way sensitivity analysis and probabilistic sensitivity analysis.Moreover,the results of the economic evaluation of 10 papers showed that(combined)vaccination or increased vaccination rates were more economical.In addition,4 of the 12 papers had a quality score>75,which were considered high-quality studies.CONCLUSIONS Although most of the included studies showed that vaccination was economical,the quality of the existing paper needed to be improved.It is recommended that subsequent studies on the economic evaluation of influenza vaccines in GBA may consider adding economic evaluations for Macao region and other cities in Guangdong of China,prioritizing dynamic models and recent data from local residents,and referring to relevant tools and guidelines to improve the standardization and scientificity of the study design.