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目的评估我国1992～2005年实施新生儿乙肝疫苗免疫预防策略的经济效果。方法在综合国内有关重要研究资料的基础上,构建我国乙肝疫苗免疫预防14年效果评估决策树模型,采用成本效益和成本效果分析指标。结果我国新生儿乙肝疫苗免疫策略使得1992～2005年出生新生儿累计避免发生乙肝病毒(HBV)感染6522.95万例(城市2442.35万例,农村4080.60万例),其中急性乙肝1304.59万例,慢性乙肝65.23万例,肝硬化6.01万例,肝癌0.60万例;每预防1例HBV感染的费用为81.99元,可获得2674.77亿元的净效益,效益成本比为51.01∶1(城市为49.59∶1,农村为51.91∶1)。结论我国新生儿乙肝疫苗免疫策略实施14年获得巨大经济效益,决策树模型应用于乙肝疫苗接种效果评估具有定量决策和综合多因素等优点。
Objective To evaluate the economic effect of implementing immunization prevention strategy of newborn hepatitis B vaccine in our country from 1992 to 2005. Methods Based on the relevant research data in China, a decision tree model for evaluation of 14-year effectiveness of hepatitis B vaccine immunization in our country was constructed. The cost-effectiveness and cost-effectiveness analysis indicators were used. Results The immunization strategy of neonatal hepatitis B in our country made 65,225,900 newborns born in 1992 ~ 2005 (24,423,500 in urban areas and 40,806,000 in rural areas), including 13,545,900 cases of acute hepatitis B and 65.23 cases of chronic hepatitis B 60,000 cases of liver cirrhosis and 60,000 cases of liver cancer. The cost of preventing one case of HBV infection is 81.99 yuan, and the net benefit of 267.477 billion yuan can be obtained, the cost-benefit ratio is 51.01:1 (49.59:1 in urban areas, rural area 51.91: 1). Conclusion The immunization strategy of neonatal hepatitis B vaccine in our country has obtained great economic benefits for 14 years. The decision tree model has many advantages such as quantitative decision making and comprehensive multifactorial evaluation for hepatitis B vaccination.