Health Service Executive Mid-West Region, 31/33 Catherine Street, Limerick, Ireland.
Eur J Public Health. 2010 Apr;20(2):213-9. doi: 10.1093/eurpub/ckp141. Epub 2009 Oct 28.
Cervical cancer is a leading cause of death worldwide, and in Ireland it is the ninth most commonly diagnosed cancer in women. Almost 100% of these cancers are caused by human papillomavirus (HPV) infection. Two newly developed vaccines against HPV infection have become available. This study is a cost-utility analysis of the HPV vaccine in Ireland, and it compares the cost-effectiveness profiles of the two vaccines.
A cost-utility analysis of the HPV vaccine in Ireland was performed using a Markov model. A cohort of screened and vaccinated women was compared with an unvaccinated screened cohort, and both cohorts were followed over their lifetimes. The model looked at uptake of services related to HPV disease in both cohorts. Outcomes were measured in quality adjusted life years (QALYs). Extensive sensitivity analysis was done.
For the base case analysis, the model showed that the incremental cost-effectiveness ratio (ICER) for quadrivalent HPV vaccination would be 25,349 euros/QALY and 30,460 euros/QALY for the bivalent vaccine. The ICER for the quadrivalent vaccine ranged from 2877 euros to 36,548 euros, and for the bivalent from 3399 euros to 45,237 euros. At current prices, the bivalent vaccine would need to be 22% cheaper than the quadrivalent vaccine in order to have equivalent cost effectiveness.
HPV vaccination has the potential to be very cost effective in Ireland. The quadrivalent vaccine is more cost effective than the bivalent vaccine.
宫颈癌是全球范围内导致死亡的主要原因之一，在爱尔兰，它是女性中第九种最常见的癌症。几乎所有这些癌症都是由人乳头瘤病毒（HPV）感染引起的。两种新开发的 HPV 感染疫苗已投入使用。本研究是对爱尔兰 HPV 疫苗的成本效益分析，比较了两种疫苗的成本效益情况。
采用马尔可夫模型对爱尔兰 HPV 疫苗进行成本效益分析。对已筛查和接种疫苗的女性队列与未接种疫苗的筛查队列进行了比较，并对两个队列的终生进行了随访。该模型考察了两个队列中与 HPV 疾病相关的服务利用率。结果以质量调整生命年（QALY）衡量。进行了广泛的敏感性分析。
在基本案例分析中，该模型表明，四价 HPV 疫苗的增量成本效益比（ICER）将为 25,349 欧元/QALY，二价疫苗为 30,460 欧元/QALY。四价疫苗的 ICER 范围为 2877 欧元至 36,548 欧元，二价疫苗的 ICER 范围为 3399 欧元至 45,237 欧元。按当前价格计算，二价疫苗的价格要比四价疫苗便宜 22%，才能具有同等的成本效益。
HPV 疫苗在爱尔兰具有很高的成本效益。四价疫苗比二价疫苗更具成本效益。
