title: [Economic evaluation on different two-dose-vaccination-strategies related to Measles, Mumps and Rubella Combined Attenuated Live Vaccine].
abstract: OBJECTIVE
  To evaluate the economic effect of Measles, Mumps and Rubella Combined Attenuated Live Vaccine (MMR) under different two-dose vaccination programs.
  
  
  METHODS
  A hypothetical birth cohort of 750 000 infants over their lifetime, was followed up from birth through death in Zhejiang province. The current MMR vaccination strategie would include three different ones: 1) Childlern were vaccinated with Measles-Rubella Combined Attenuated Live Vaccine and MMR, respectively at the age of 8 months and 18 months. 2) Children receive MMR at 8 months and 18 months, 3) Strategy 1 plus an additional vaccination of MMR at 4 years of age. Incremental cost-effectiveness ratio (ICER), incremental cost-benefit ratio (ICBR) and incremental net benefit (INB) were applied to calculate the health economic difference for Strategy 2 and Strategy 3 as compared to Strategy 1. Univariate sensitivity analysis was used to assess the robustness of results with main parameters, including the rate of immunization coverage, effectiveness of the vaccines, incidence and burdens of the related diseases, cost of vaccines and the vaccination program itself.
  
  
  RESULTS
  ICER, ICBR and INB for Strategy 2 and Strategy 3 appeared as 2 012.51∶1 RMB Yuan per case and 4 238.72∶1 RMB Yuan per case, 1∶3.14 and 1∶1.58, 21 277 800 RMB Yuan and 9 276 500 RMB Yuan, respectively. Only slight changes (<20%) were found under the univariate sensitivity analysis, with varied values on main parameters.
  
  
  CONCLUSIONS
  Based on the current national immunization program, infants vaccinated with MMR at 8 months of age, generated more health economic effects than the Strategy 3.
authors.affiliation: Expanded Program Immunization Department of Zhejiang Provincial Center for Diseases Control and Prevention, Hangzhou 310051, China.
authors.forename: H Q
authors.initials: HQ
authors.lastname: He
authors.forename: B
authors.initials: B
authors.lastname: Zhang
authors.forename: R
authors.initials: R
authors.lastname: Yan
authors.forename: Q
authors.initials: Q
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Fu
authors.forename: X W
authors.initials: XW
authors.lastname: Tang
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
authors.forename: X
authors.initials: X
authors.lastname: Deng
authors.forename: S Y
authors.initials: SY
authors.lastname: Xie
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007115:Immunization Schedule; D007223:Infant; D008457:Measles / Q000191:economics / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000191:economics*; D009107:Mumps / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D012409:Rubella / Q000191:economics / Q000517:prevention & control*; D014611:Vaccination; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000191:economics*; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000191:economics
chemical_list: D022542:Measles-Mumps-Rubella Vaccine; D014613:Vaccines, Attenuated; D017778:Vaccines, Combined