Cost-effectiveness analysis of rabies immunization strategy based on dynamic-decision tree model
10.3760/cma.j.issn.0253-9624.2019.08.002
- VernacularTitle: 基于动力学-决策树模型的狂犬病免疫策略成本效用分析
- Author:
Donglei WANG
1
;
Xuefeng ZHANG
2
;
Xiaochen WANG
2
;
Yutong WANG
1
;
Rong ZHANG
1
;
Yaoyao CHEN
1
;
Qiang WANG
1
;
Na YUE
1
;
Changjun BAO
2
;
Minghao ZHOU
2
;
Hui JIN
1
Author Information
1. Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China
2. Institute of Acute Infectious Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
- Publication Type:Journal Article
- Keywords:
Rabies;
Costs and cost analysis;
Dynamic-decision tree;
Immune strategy
- From:
Chinese Journal of Preventive Medicine
2019;53(8):804-810
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the cost-utility of different immunization strategies for rabies in China, and to provide a reference for determining the optimal immunization strategy.
Methods:The system dynamics model was used to simulate the epidemic of canine rabies and a decision tree model was conducted to analysis different immune strategies. Relevant probabilities were obtained through literature search and on-site investigation. Sensitivity analysis was used to explore the important influenced factors.
Results:At baseline, from a social perspective, 70% vaccination of dogs was the optimal strategy compared to current vaccination strategy (43% vaccination in dogs, human category-Ⅱ exposure vaccination/category-Ⅲ exposure vaccination combined with RIG). The total cost was 14 084 354 CNY, and the total utility value was 22 078 616.23 QALYs, and the incremental cost-utility ratio was-62 148 147 CNY/QALY; if human vaccination was considered, 55% vaccination of dogs combined with strategy one was the optimal strategy, its incremental cost-utility ratio was-444 620 557 CNY/QALY. The probability that an injured dog carries rabies virus was the most sensitive parameter. When it was greater than 0.005 03, strategy four was the optimal strategy. When it was less than 82/100 000, strategy one was the optimal strategy; when it was between 82/100 000 and 120/100 000, strategy two was the optimal strategy; when it was between 120/100 000 and 503/100 000, strategy two was the optimal strategy.
Conclusion:It was conducive to increase the vaccination coverage of canine for the prevention and control of rabies.
