RTI International, Health Preference Assessment, USA.
Soc Sci Med. 2011 Jul;73(2):226-34. doi: 10.1016/j.socscimed.2011.05.029. Epub 2011 Jun 12.
About 530,000 women develop cervical cancer worldwide and 275,000 die from the disease each year. Eighty percent of these deaths occur in developing countries. In Vietnam, cervical cancer has recently emerged as the most common type of cancer in women, and there are no national screening programs for cervical cancer. Since 2009, two different human papillomavirus (HPV) vaccines have been licensed for use in Vietnam, but access to these vaccines is generally limited to people who live in urban areas. Studies have shown that HPV vaccination may be cost-effective in cervical cancer prevention in Vietnam, depending on vaccination costs. Given that current HPV vaccines are expensive and public health funding for supporting a rapid introduction of the vaccine is limited, expanding and sustaining access to the HPV vaccine may require alternative financing mechanisms, such as fees-based immunization services. A conjoint analysis study was conducted with mothers of girls 9-17 years of age in Vinh Long Province in Vietnam to estimate the mothers' demand for HPV vaccines for their daughters and to measure the tradeoffs between vaccine fees and vaccine uptake. The results suggest that the demand for HPV vaccines was high, increased with vaccine effectiveness and duration of effectiveness, and decreased with vaccine cost. Vaccine effectiveness was the most important vaccine attribute to these mothers, followed by duration of effectiveness. The predicted probability of respondents buying an HPV vaccine that was 70% effective for 10 years varied by the price, ranging from 30% when the vaccine price was $353 per course, to 68% when the vaccine cost $6 per course. As expected, demand and predicted purchase probability were higher among groups with higher socioeconomic status.
全球每年约有 53 万名女性被诊断为宫颈癌，27.5 万人死于宫颈癌。这些死亡人数中有 80%发生在发展中国家。在越南，宫颈癌最近已成为女性最常见的癌症类型，但越南没有全国性的宫颈癌筛查计划。自 2009 年以来，两种不同的人乳头瘤病毒（HPV）疫苗已在越南获得许可使用，但这些疫苗的接种通常仅限于居住在城市地区的人群。研究表明，HPV 疫苗接种在宫颈癌预防方面在越南可能具有成本效益，这取决于疫苗接种成本。鉴于目前 HPV 疫苗价格昂贵，且公共卫生资金支持疫苗快速推广的能力有限，扩大和维持 HPV 疫苗的可及性可能需要替代融资机制，例如基于费用的免疫服务。本研究在越南永隆省对 9-17 岁女孩的母亲进行了一项联合分析研究，以估计母亲对其女儿 HPV 疫苗的需求，并衡量疫苗费用和疫苗接种率之间的权衡。结果表明，HPV 疫苗的需求很高，随着疫苗的有效性和有效性持续时间的增加而增加，随着疫苗成本的增加而降低。疫苗有效性是这些母亲最重要的疫苗属性，其次是有效性持续时间。在假设疫苗价格为 353 美元/疗程时，预测对有效率为 70%且有效期为 10 年的 HPV 疫苗的购买概率为 30%，当疫苗价格为 6 美元/疗程时，预测购买概率为 68%。正如预期的那样，在社会经济地位较高的群体中，需求和预测的购买概率更高。
