Health Technology Assessment Public Health Unit, Institute of Hygiene, Catholic University of the Sacred Heart - Rome, Italy; Clinical Medicine and Public Health Unit, Sapienza University of Rome, Italy.
Vaccine. 2010 Apr 26;28(19):3379-84. doi: 10.1016/j.vaccine.2010.02.080. Epub 2010 Mar 1.
Health Technology Assessment (HTA) approach was applied to Human Papilloma Virus (HPV) vaccine in the Italian context.
Epidemiology and costs of HPV infection and related diseases, vaccine efficacy, clinical and economic impact of the HPV vaccination and women's knowledge and attitudes towards vaccination were assessed.
HPV infections pooled prevalence in Italy was 19% (95%CI: 10-30%) and cervical cancer incidence was 9.8/100,000 per year. The mean costs for in situ and invasive carcinoma hospitalisation were estimated respectively in euro1745.87 and euro2616.16. HPV vaccines have demonstrated high efficacy and good safety profile. The meta-analysis on efficacy results in preventing persistent cervical infections by HPV16 and 18 for both HPV vaccines resulted in 87% (95%CI: 80-91%) and 78% (95%CI: 62-87%). Modelling the impact of vaccination with bivalent vaccine, it would reduce cancer cases by 67% and be cost-effective, with a cost per Quality Adjusted Life Years (QALYs) gained of euro22,055.
The thoroughness of the evaluation allowed us accounting for all the aspects of HPV infection/diseases. The HTA report on the HPV vaccine demonstrated to be a comprehensive tool for an informed decision making process.
在意大利的背景下，采用健康技术评估（HTA）方法评估了人乳头瘤病毒（HPV）疫苗。
评估了 HPV 感染和相关疾病的流行病学和成本、疫苗的功效、HPV 疫苗接种的临床和经济影响以及女性对疫苗接种的知识和态度。
意大利 HPV 感染的总流行率为 19%（95%CI：10-30%），宫颈癌发病率为每年 9.8/100,000。原位癌和浸润性癌住院费用的平均值分别估计为 1745.87 欧元和 2616.16 欧元。HPV 疫苗已证明具有高功效和良好的安全性。针对两种 HPV 疫苗预防 HPV16 和 18 持续性宫颈感染的疗效的荟萃分析结果显示，预防效果分别为 87%（95%CI：80-91%）和 78%（95%CI：62-87%）。通过接种二价疫苗进行建模，它将减少 67%的癌症病例，并具有成本效益，每获得一个质量调整生命年（QALY）的成本为 22,055 欧元。
评估的全面性使我们能够考虑到 HPV 感染/疾病的所有方面。HPV 疫苗的 HTA 报告证明是一个用于知情决策过程的综合工具。
