Department of Medical Microbiology-Molecular Virology, University Medical Center Groningen, The Netherlands.
J Infect Dis. 2011 Aug 1;204(3):377-84. doi: 10.1093/infdis/jir281.
Cervical cancer is caused by infection with human papillomavirus (HPV). Several countries have implemented vaccination programs against HPV for teenage girls before sexual debut. However, recent clinical trials have demonstrated that vaccination of older women is highly effective as well. Accordingly, it has been suggested that these older women should also be offered vaccination. Here, the cost-effectiveness of HPV vaccination for older women was assessed.
A Markov model was used to estimate age-specific health benefits and cost savings of HPV vaccination for women 12-50 years of age, in the Netherlands. Sensitivity analyses were performed to test the robustness of the outcomes. State-of-the-art health-economic methods were used, and international health-economic guidelines were followed.
HPV vaccination is highly cost-effective for girls aged 12-16 years. Remarkably, cost-effectiveness only slowly declines with increasing age of the vaccinees up to 25 years. Indeed, substantial health benefits can be obtained by vaccinating women in this age group at acceptable costs. Beyond this age, cost-effectiveness of HPV-vaccination rapidly declines.
Not only HPV vaccination of girls before sexual debut is a highly effective and cost-effective strategy for prevention of cervical cancer, but also vaccination of women until the age of 25 years is generally cost-effective.
宫颈癌是由人乳头瘤病毒（HPV）感染引起的。一些国家已经在少女初潮前实施了针对 HPV 的疫苗接种计划。然而，最近的临床试验表明，为老年女性接种疫苗同样非常有效。因此，有人建议也应为这些老年女性提供疫苗接种。在此，评估了为老年女性接种 HPV 疫苗的成本效益。
使用马尔可夫模型来估算荷兰 12-50 岁女性接种 HPV 疫苗的特定年龄的健康获益和成本节约。进行了敏感性分析以检验结果的稳健性。使用了最先进的健康经济学方法，并遵循了国际健康经济学指南。
12-16 岁女孩接种 HPV 疫苗具有很高的成本效益。值得注意的是，疫苗接种者的年龄不断增加，疫苗的成本效益仅缓慢下降，直至 25 岁。实际上，通过以可接受的成本为该年龄组的女性接种疫苗，可以获得大量的健康益处。超过这个年龄，HPV 疫苗接种的成本效益迅速下降。
不仅在少女初潮前为女孩接种 HPV 疫苗是预防宫颈癌的一种非常有效且具有成本效益的策略，而且在 25 岁之前为女性接种疫苗通常也是具有成本效益的。
