comparative economic evaluation of haemophilus influenzae type b vaccination in belarus and uzbekistan比较经济评价b型流感嗜血杆菌疫苗接种在白俄罗斯和乌兹别克斯坦.pdfVIP

Comparative Economic Evaluation of Haemophilus influenzae Type b Vaccination in Belarus and Uzbekistan 1 1 2 3 4 Ulla K. Griffiths *, Andrew Clark , Veronika Shimanovich , Irina Glinskaya , Dilorom Tursunova , Lucia 4 5 6 1 Kim , Liudmila Mosina , Rana Hajjeh , Karen Edmond 1 Hib Initiative, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Republican Centre for Hygiene, Epidemiology and Public Health, Minsk, Belarus, 3 Minsk City Centre for Hygiene and Epidemiology, Minsk, Belarus, 4 Ministry of Health, Tashkent, Uzbekistan, 5 WHO Regional Office for Europe, Copenhagen, Denmark, 6 Center for Disease Control, Atlanta, Georgia, United States of America Abstract Background: Hib vaccine has gradually been introduced into more and more countries during the past two decades, partly due to GAVI Alliance support to low-income countries. However, since Hib disease burden is difficult to establish in settings with limited diagnostic capacities and since the vaccine continues to be relatively expensive, some Governments remain doubtful about its value leading to concerns about financial sustainability. Similarly, several middle-income countries have not introduced the vaccine. The aim of this study is to estimate and compare the cost-effectiveness of Hib vaccination in a country relying on self-financing (Belarus) and a country eligible for GAVI Alliance support (Uzbekistan). Methods and Findings: A decision analytic model was used to estimate morbidity and mortality from Hib meningitis, Hib pneumonia and other types of Hib disease with and without the vaccine. Treatment costs were attached to each disease event. Data on disease incidence, case fatality ratio