医療の Cost- Benefit Analysis

BCG接種の費用と効果

抄録

Cost and Benefit of BCG vaccination was analysed during 1958 to 1978 in Japan.
The reduction of active cases of tuberculosis during the study period was estimated by simulation analysis using our epidemetric model of tuberculosis which was already reported in 1970, under the condition that the present tuberculosis control programme including BCG vaccination was continued (Schedule A), or that BCG vaccination programme was stopped and the protective power of previous BCG became null at 1958 and the other tuberculosis control programme was the same as Schedule A. For Schedule A, the protective power of BCG was 50% and fell by one percent per year for the study period.
At the end of 1978, 270 thousands cases of tuberculosis might have been saved, and altogether 4.17 millions person-years might be reduced during 20 years of the study period.
The costs of BCG vaccination and medicare for one case was calculated from the annual expenditure for tuberculosis in all Japan, for 1958 to 1970 and estimated during 1971 to 1978 provided that their cost increased at 5% for year.
Total cost of BCG vaccination was estimated 9.6 billions yen until 1978 and the saving in expenditure of the medicare for 270 thousands active cases totalled 4.17 millions person-years costs 325.9 billions yen which did not include the indirect cost of medicare and the loss of production.
Even if BCG vaccination costs ten times as high as the present estimate, vaccination would have been a very profitable investment.