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Abstract(s)
Introdução: A doença meningocócica, causada por infeção por Neisseria meningitidis,
constitui uma elevada carga de doença e acarreta elevados custos a cada país. Os
objetivos gerais desta dissertação são: analisar a doença meningocócica, as estratégias
de prevenção adotadas no Mundo e em Portugal, bem como, analisar as avaliações
económicas na utilização da vacina quadrivalente para os serogrupos A, C, W e Y.
Métodos: Foram realizadas uma pesquisa bibliográfica e uma revisão sistemática da
literatura. Na pesquisa sistemática foram utilizadas as bases de dados B-ON, PUBMED,
EBSCO, Cochrane, British National Health Services Economic Evaluation Database
(NHS EED), Science Direct, Scopus e Web of Science. Os critérios de inclusão utilizados
foram construídos com metodologia PICO e incluíam apenas artigos com avaliações
económicas completas, tendo sido excluídos os que apresentassem avaliações parciais.
Resultados: A doença meningocócica no Mundo apresenta uma elevada incidência. Em
Portugal, apesar da introdução de estratégias de prevenção primária universal para os
serogrupos C e B (vacinação), ainda não existem estratégias instauradas para os
serogrupos Y e W. A revisão sistemática realizada identificou em sete dos treze artigos
incluídos, que a estratégia com a vacina quadrivalente para os serogrupos A, C, W e Y
não seria custo-efetivas considerando a incidência do país e o preço da vacina. As
estratégias em que esta vacina foi custo-efetiva apresentavam limiares de custoefetividade muito elevados, e em alguns casos foi considerada custo-efetiva apesar de
ultrapassar o limiar.
Conclusão: A incidência da doença meningocócica em Portugal está acima da média da
União Europeia, tendo como causa os serogrupos B, C, W, e Y. A relação custoefetividade da vacina quadrivalente para os serogrupos A, C, W e Y é ainda dúbia, sendo
importante considerar a incidência e preço da vacina no país antes da decisão de
implementar esta vacina.
Introduction: Meningococcal disease, caused by infection due to Neisseria meningitidis, can have a high burden of disease and entails excess costs for each country. The purpose of this dissertation is to analyse meningococcal disease and the preventive strategies adopted in countries over the world and Portugal, as well as to analyse economic evaluations of the quadrivalent vaccine for serogroups A, C, W and Y. Methods: A narrative literature review and a systematic literature review were conducted. In the latter, a systematic search was carried out on the B-ON, PUBMED, EBSCO, Cochrane, British National Health Services Economic Evaluation Database (NHS EED), Science Direct, Scopus and Web of Science databases. The inclusion criteria used were based on the PICO methodology and allowed only articles that were full economic evaluations and excluded articles that presented only partial economic evaluations. Results: Meningococcal disease in the World still presents a high incidence. Portugal, despite the introduction of universal preventive measures for serogroups C and B (vaccination), still has no measures in place for Y and W. The systematic review conducted identified in seven of the thirteen included articles the strategies with the quadrivalent vaccine for serogroups A, C, W and Y were not cost-effective considering the incidence of disease and the price of the vaccine. The strategies in which this vaccine was considered cost-effective had extremely high cost-effectiveness thresholds and, in some cases, it was considered cost-effective despite being above the threshold. Conclusion: Incidence of meningococcal disease in Portugal is higher than in the European Union, due to serogroups B, C, W, and Y. The cost-effectiveness of the quadrivalent vaccine for serogroups A, C, W and Y is still dubious, it is important to consider the incidence of the disease and the price of the vaccine in the country before the decision to implement this vaccine.
Introduction: Meningococcal disease, caused by infection due to Neisseria meningitidis, can have a high burden of disease and entails excess costs for each country. The purpose of this dissertation is to analyse meningococcal disease and the preventive strategies adopted in countries over the world and Portugal, as well as to analyse economic evaluations of the quadrivalent vaccine for serogroups A, C, W and Y. Methods: A narrative literature review and a systematic literature review were conducted. In the latter, a systematic search was carried out on the B-ON, PUBMED, EBSCO, Cochrane, British National Health Services Economic Evaluation Database (NHS EED), Science Direct, Scopus and Web of Science databases. The inclusion criteria used were based on the PICO methodology and allowed only articles that were full economic evaluations and excluded articles that presented only partial economic evaluations. Results: Meningococcal disease in the World still presents a high incidence. Portugal, despite the introduction of universal preventive measures for serogroups C and B (vaccination), still has no measures in place for Y and W. The systematic review conducted identified in seven of the thirteen included articles the strategies with the quadrivalent vaccine for serogroups A, C, W and Y were not cost-effective considering the incidence of disease and the price of the vaccine. The strategies in which this vaccine was considered cost-effective had extremely high cost-effectiveness thresholds and, in some cases, it was considered cost-effective despite being above the threshold. Conclusion: Incidence of meningococcal disease in Portugal is higher than in the European Union, due to serogroups B, C, W, and Y. The cost-effectiveness of the quadrivalent vaccine for serogroups A, C, W and Y is still dubious, it is important to consider the incidence of the disease and the price of the vaccine in the country before the decision to implement this vaccine.
Description
Keywords
Avaliação Económica Doença Meningocócica Prevenção Primária Vacina Menacwy Vacinação