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Economic Analysis of Pandemic Influenza Vaccination Strategies in Singapore 英文参考文献
EconomicAnalysisofPandemicInfluenzaVaccination
StrategiesinSingapore
VernonJ.Lee1,2,3*,MeiYinTok1,VincentT.Chow4,KaiHongPhua5,EngEongOoi6,7,PaulA.Tambyah8,
MarkI.Chen7,9
1CenterforHealthServicesResearch,NationalUniversityofSingapore,Singapore,Singapore,2DepartmentofEpidemiologyandPublicHealth,NationalUniversityof
Singapore, Singapore, Singapore, 3Biodefence Center, Ministry of Defence, Singapore, Singapore, 4Department of Microbiology, National University of Singapore,
Singapore,Singapore,5LeeKuanYewSchoolofPublicPolicy,Singapore,Singapore,6DefenceScienceOrganizationNationalLaboratories,Singapore,Singapore,7Duke-
National University of Singapore Graduate Medical School, Singapore, Singapore, 8Department of Medicine, National University of Singapore, Singapore, Singapore,
9CommunicableDiseaseCenter,TanTockSengHospital,Singapore,Singapore
Abstract
Background:Allinfluenzapandemicplansadvocatepandemicvaccination.However,fewstudieshaveevaluatedthecost-
effectivenessofdifferentvaccinationstrategies.Thispapercomparestheeconomicoutcomesofvaccinationcomparedwith
treatmentwithantiviralagentsalone,inSingapore.
Methodology: We analyzed the economic outcomes of pandemic vaccination (immediate vaccination and vaccine
stockpiling)comparedwithtreatment-onlyinSingaporeusingadecision-basedmodeltoperformcost-benefitandcost-
effectivenessanalyses.Wealsoexploredtheannualinsurancepremium(willingnesstopay)dependingontheperceived
riskofthenextpandemicoccurring.
PrincipalFindings:Thetreatment-onlystrategyresultedin690deaths,13,950hospitalizationdays,andeconomiccostof
USD$497 million. For immediate vaccination, at vaccine effectiveness of .55%, vaccination was cost-beneficial over
treatment-only.Vaccinestockpilingisnotcost-effectiveinmostscenariosevenwith100%vaccineeffectiveness.Theannual
insurancepremiumwashighestwithimmediatevaccination,andwaslowerwithincreaseddurationtothenextpandemic.
Thepremiumwasalsohigherwithhighervaccineeffectiveness,attackrates,andcase-fatalityrates.Stockpilingwit
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