Health Economic Statistics, Biostatistics and Research Decision Sciences, Merck Research Laboratories, North Wales, PA 19454-1099, USA.
J Med Econ. 2010 Mar;13(1):110-8. doi: 10.3111/13696990903546013.
A transmission dynamic model was used to assess the epidemiological and economic impact of a quadrivalent human papillomavirus (HPV) (6/11/16/18) vaccine in preventing cervical cancer, cervical intraepithelial neoplasia grades 2 and 3 (CIN 2/3), CIN 1 and genital warts in Hungary.
The routine vaccination of 12-year-old girls and the routine vaccination of 12-year-old girls plus a temporary catch-up programme for girls and women aged 12-24 years was evaluated.
The model projected that at year 100, both strategies could reduce the incidence of HPV 6/11/16/18-related cervical cancer, CIN 2/3, CIN 1 and genital warts cases among Hungarian women by 90%, 90%, 85% and 93%, respectively. Twenty-five years after the introduction of HPV vaccination in the population, routine vaccination of girls by the age of 12 reduced the cumulative number of cases of cervical cancer, CIN 2/3, CIN 1 and genital warts by 685, 13,473, 3,423 and 163,987, respectively. The incremental cost-effectiveness ratios of the two vaccination strategies were €9,577 and €10,646 per quality-adjusted life-year (QALY) gained over a time horizon of 100 years.
The model did not account for the health and economic impact of other HPV diseases which may result from HPV 16, 18, 6, and 11 infections such as vaginal, vulvar, penile, anal and head-neck cancers, and recurrent respiratory papillomatosis. Epidemiological data from Hungary on these other HPV diseases as well genital warts are needed.
A quadrivalent HPV vaccination programme can reduce the incidence of cervical cancer, CIN and genital warts in Hungary at a cost-per-QALY ratio within the range defined as cost effective.
利用传播动力学模型评估四价人乳头瘤病毒（HPV）（6/11/16/18）疫苗预防宫颈癌、宫颈上皮内瘤变 2 级和 3 级（CIN 2/3）、CIN1 和生殖器疣在匈牙利的流行病学和经济影响。
评估了对 12 岁女孩进行常规疫苗接种以及对 12 岁女孩和 12-24 岁女孩和妇女进行临时补种计划的效果。
模型预测，在第 100 年，两种策略都可以将匈牙利女性 HPV 6/11/16/18 相关宫颈癌、CIN 2/3、CIN1 和生殖器疣病例的发病率分别降低 90%、90%、85%和 93%。在 HPV 疫苗引入人群 25 年后，12 岁女孩的常规疫苗接种减少了宫颈癌、CIN 2/3、CIN1 和生殖器疣的累积病例数，分别减少了 685、13473、3423 和 163987 例。两种疫苗接种策略在 100 年时间内的增量成本效益比分别为每获得一个质量调整生命年（QALY）增加 9577 欧元和 10646 欧元。
该模型未考虑 HPV 16、18、6 和 11 感染引起的其他 HPV 疾病（如阴道、外阴、阴茎、肛门和头颈部癌症以及复发性呼吸道乳头瘤病）对健康和经济的影响。匈牙利需要这些其他 HPV 疾病以及生殖器疣的流行病学数据。
四价 HPV 疫苗接种计划可以降低匈牙利宫颈癌、CIN 和生殖器疣的发病率，其成本效益比在定义的范围内是合理的。
