研究背景 : 由肺炎鏈球菌所引起的疾病會導致較高的發病率和死亡率，其中又以5歲以下孩童為高危險群。7價肺炎球菌疫苗（PCV7）與13價肺炎球菌疫苗（PCV13）分別在2005年與2011年被引進臺灣。
研究目的 : 本研究欲推估臺灣地區五歲以下孩童肺炎鏈球菌疫苗接種計劃的成本效果和疫苗最合適之價格，做為疫苗接種政策的參考依據。
研究方法 : 使用醫療和社會觀點之決策樹模型，以臺灣地區五歲以下孩童肺炎鏈球菌感染造成之疾病、經濟負擔以及疫苗效力，評估2010 年出生兒童其肺炎鏈球菌疫苗接種計畫之決策。使用健保資料庫2001-2004 年門診檔與住院檔與臺灣疾病管制局的法定傳染病個案通報系統資料庫，計算肺炎鏈球菌造成之醫療成本與疾病負擔。
結果 : 接種PCV7疫苗，可減少約24,343個病例數，接種PCV13疫苗，可減少約30,741個病例數。從醫療及社會這兩個觀點來看，全面接種三劑PCV7疫苗，每增加一個QALY需額外投入14,348,572元及12,097,963元；全面接種三劑PCV13疫苗，每增加一個QALY需額外投入11,204,969元及8,954,360元。將投入的成本降至小於臺灣三個平均每人的國內生產毛額（GDP）作為標準，來找出疫苗最合適之價格。從醫療觀點評估，PCV7疫苗最適合價格為每人每劑最高可至320元，PCV13 疫苗為每人每劑最高至445元；從社會觀點評估，PCV7疫苗最適合價格最高可至790元，PCV13疫苗則為1,040 元。
結論 :雖然臺灣以目前疫苗價格並不符合成本效果，但推動肺炎鏈球菌疫苗全面施打計畫可以顯著降低臺灣五歲以下兒童因肺炎鏈球菌所造成的疾病負擔。

Background： Pneumococcal diseases caused by Streptococcus pneumoniae can lead to significant morbidity and mortality in children under the age of 5 years. In Taiwan, the 7-valent pneumococcal conjugate vaccine (PCV7) and the 13-valent pneumococcal conjugate vaccine (PCV13) have been available since 2005 and 2011, respectively.
Objectives：This study explored the cost-effectiveness of national pneumococcal vaccination program and the break-even price of the pneumococcal vaccines in Taiwan.
Methods：From health care and societal perspectives, a decision tree model was used to assess the pneumococcal vaccination program of 2010 birth cohort by the disease burden, economic burden and vaccine efficacy from birth to aged 5 years. The disease rate and cost data were esimated from National Notifiable Disease Surveillance System (NNDSS) and the National Health Insurance Research database year 2001-2004 data.
Result：The PCV7 vaccine could prevent at least 24,343 disease episodes. The PCV13 could prevent at least 30,741 disease episodes. From health care perspective, the incremental cost-effectiveness ratio (ICER) in PCV7 pneumococcal vaccination program (2+1 dose schedule) was NT$14,348,572 per QALY. The PCV13 pneumococcal vaccination program (2+1 dose schedule) was NT$11,204,969. From societal perspective, the ICER was NT$12,097,963 in PCV7 pneumococcal vaccination program, the ICER was NT$8,954,360 in PCV13 pneumococcal vaccination program. Our study use ICER (in QALY) was between 3 times of GDP as a criterion. From the health care perspective, the break-even price for of PCV7 vaccine was NT$320, PCV13 vaccine was NT$445. From the societal perspective, the break-even price for these two vaccines was NT$790 and NT$1,040, respectively.
Conclusion：Although pneumococcal vaccines would unlikely be cost-saving at present cost of vaccine in Taiwan, pneumococcal vaccination program could significantly reduce the disease burden in Taiwan,

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