目的 分析2015—2022年西藏棘球蚴病人群筛查和患者治疗的成本-效果，为制定或调整棘球蚴病防治策略和措施提供参考。方法 从西藏自治区包虫病防治工作年报系统收集2015—2022年西藏棘球蚴病人群筛查和患者治疗方面投入的成本、查出新患者数、治疗效果等相关数据。计算各年度、各地区/市的筛查和治疗的成本-效果。用增量成本-效果比（ICER）反映西藏棘球蚴病实际发生的伤残调整寿命年（DALY）与无干预下估算的DALY之间的差异∆E与查治成本∆C之间的关系。ICER与人均国内生产总值（GDP）的比值作为支付意愿阈值（WTP）。不同年份之间治疗总有效率的差异用K-W检验，使用Bonferroni法进行两两比较，并校正P值。结果 2015—2022年西藏在棘球蚴病人群筛查经费投入总成本为5 417.1万元，2017年最高（2 762.4万元）。2017—2022年新发现患者的筛查成本-效果比呈逐年增高趋势，由2017年的1 641元/人升高到2022年的21 131元/人。2022年，日喀则市筛查新发现患者率最高（0.10%），山南市最低（0.00%），相应的筛查成本-效果比分别为1.0万元/人和20.9万元/人。2015—2022年西藏患者治疗投入总成本为8 056.0万元，2018年度最高（3 905.5万元）。其中手术治疗成本占比73.0%（5 880.7万元），药物治疗成本占比27.0%（2 175.4万元）。西藏2015—2022年患者总治愈率为11.1%，治愈率年度变化趋势不明显，好转率呈上升趋势，在2022年达到了68.6%。西藏自治区实际DALY低于无干预情况下的DALY，挽回的DALY损失由2017年的6 293.03增加到了2022年的11 487.84。2017—2022年西藏棘球蚴病人群筛查及患者治疗ICER平均为11 460.3元/年，WTP为0.196。结论 西藏2017—2022年棘球蚴病的人群筛查和患者治疗方面投入较大，资金利用效率较高。通过普查，发现了大量处于早期的棘球蚴病患者，并积极安排了手术救治和药物治疗。但目前筛查效率较低的地区已不再适合大规模人群筛查，建议因地制宜地调整筛查策略和方式。在棘球蚴病患者治疗方面，建议加强手术诊疗培训，提高手术水平和效果，加强药物治疗患者的规范管理和服药依从性，进一步提高棘球蚴病患者的救治效果。

Objective To analyze the cost-effectiveness of population screening and patient treatment for echinococcosis in Xizang from 2015 to 2022, so as to provide insights into formulation or adjustment of the echinococcosis control strategies and measures. Methods The costs for population echinococcosis screening and echinococcosis patient treatment, newly diagnosed echinococcosis cases, and treatment efficiency in Xizang from 2015 to 2022 were collected from the annual report system of the Hydatid Disease Prevention and Control Program in Xizang Autonomous Region, and the cost-effectiveness of echinococcosis screening and treatment was calculated in each year from 2015 to 2022 and in each prefecture/city. The incremental cost-effectiveness atio (ICER) was used to examine the association of the difference (∆E) between the actual disability-adjusted life years (DALYs) due to echinococcosis and the estimated DALYs without interventions with the total costs of echinococcosis screening and treatment (∆C) in Xizang, and the willingness-to-pay (WTP) threshold was measured as a ratio of ICER to per capita gross domestic product (GDP). The difference in the overall response to treatment was tested for statistical significance with Kruskal-Wallis (K-W) test among years, followed by pairwise comparisons with Bonferroni corrections. Results The total costs of population screening for echinococcosis were 54.171 million yuan in Xizang from 2015 to 2022, with the highest in 2017 (27.624 million yuan). The cost-effectiveness ratio for screening newly detected echinococcosis cases appeared a tendency towards a rise over years from 2017 to 2022, from 1 641 yuan/person in 2017 to 21 131 yuan/person in 2022. The proportion of newly detected echinococcosis cases by screening was highest in Shigatse City (0.10%) and lowest in Shannan City (0.00%) in 2022, and the cost-effectiveness ratios were 10 000 yuan/person and 209 000 yuan/person, respectively. The total costs for echinococcosis patient treatment were 80.560 million yuan in Xizang from 2015 to 2022, peaking in 2018 (39.055 million yuan), including 58.807 million yuan for surgical treatment (73.0%) and 21.754 million yuan for drug treatment (27.0%). The overall cure rate of echinococcosis patients was 11.1% in Xizang from 2015 to 2022, with no significant annual trends in cure rates; however, the proportion of improvements appeared a tendency towards a rise during the study period, with 68.6% in 2022. The actual DALYs due to echinococcosis were lower than the estimated DALYs without interventions in Xizang, and the averted DALYs loss increased from 6 293.03 in 2017 to 11 487.84 in 2022. The average ICER for population echinococcosis screening and patient treatment was 11 460.3 yuan/year in Xizang from 2017 to 2022, with a WTP of 0.196. Conclusion Xizang has given large financial investments and achieved a satisfactory efficiency for population screening and patient treatment of echinococcosis from 2017 to 2022, with a high fund utilization efficiency. Through comprehensive screening, a large number of early-stage echinococcosis patients were identified, and surgical treatments and medication were actively arranged. However, regions with currently low screening efficiency are no longer suitable for large-scale population screening. It is recommended to adjust screening strategies and methods according to local conditions. For the treatment of echinococcosis patients, it is advised to enhance surgical training to improve surgical standards and outcomes, strengthen the standardized management of patients undergoing drug treatment, and improve medication adherence, thereby further enhancing the treatment effectiveness for echinococcosis patients.