Brisson Marc, Van de Velde Nicolas, Boily Marie-Claude
Département de médecine sociale et préventive, Université Laval, Québec, Qué., Canada.
Public Health Genomics. 2009;12(5-6):343-51. doi: 10.1159/000214924. Epub 2009 Aug 11.
With promising efficacy results from randomized control trials of human papillomavirus (HPV) vaccines and the availability of new screening paradigms, policymakers are being asked to make recommendations and decisions regarding the optimal strategies to reduce HPV infection and disease. Such decisions are increasingly being made with significant input from mathematical and economic models. The demand for modeling has resulted in the publication of numerous mathematical models looking at the cost-effectiveness of HPV vaccination.
To review published models that have been used to evaluate the cost-effectiveness of HPV vaccination in developed countries and highlight points of consensus and disagreement in methods and findings.
This review consists of cost-effectiveness studies published in the peer-reviewed literature before August 2008.
Despite variations in methods, modeling studies are producing consistent conclusions: (1) vaccinating young girls against HPV is likely to be cost- effective; (2) vaccinating boys will most likely not be cost- effective in countries that can reach high coverage rates in girls, and (3) results are most sensitive to the duration of vaccine protection. However, results from analyses examining the effectiveness and cost-effectiveness of vaccinating boys when coverage rates are low (< or = 80%) and catch-up strategies have reached conflicting conclusions.
鉴于人乳头瘤病毒（HPV）疫苗随机对照试验取得了有前景的疗效结果，且出现了新的筛查模式，政策制定者被要求就降低HPV感染和疾病的最佳策略提出建议并做出决策。此类决策越来越多地受到数学和经济模型的重大影响。对建模的需求导致众多关于HPV疫苗接种成本效益的数学模型得以发表。
回顾已发表的用于评估发达国家HPV疫苗接种成本效益的模型，并突出方法和研究结果方面的共识与分歧点。
本综述涵盖2008年8月之前在同行评审文献中发表的成本效益研究。
尽管方法存在差异，但建模研究得出了一致的结论：（1）为年轻女孩接种HPV疫苗可能具有成本效益；（2）在能够实现女孩高接种率的国家，为男孩接种疫苗很可能不具有成本效益；（3）结果对疫苗保护期最为敏感。然而，关于在接种率较低（≤80%）时为男孩接种疫苗的有效性和成本效益以及补种策略的分析结果得出了相互矛盾的结论。
