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九价人乳头瘤病毒疫苗在美国的影响及成本效益:来自简化传播模型的估计

The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model.

作者信息

Chesson Harrell W, Markowitz Lauri E, Hariri Susan, Ekwueme Donatus U, Saraiya Mona

机构信息

a Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta , GA , USA.

b Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , GA , USA.

出版信息

Hum Vaccin Immunother. 2016 Jun 2;12(6):1363-72. doi: 10.1080/21645515.2016.1140288. Epub 2016 Feb 18.

Abstract

INTRODUCTION

The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58.

METHODS

We adapted a previously published model of the impact and cost-effectiveness of 4vHPV to include the 5 additional HPV types in 9vHPV. The vaccine strategies we examined were (1) 4vHPV for males and females; (2) 9vHPV for females and 4vHPV for males; and (3) 9vHPV for males and females. In the base case, 9vHPV cost $13 more per dose than 4vHPV, based on available vaccine price information.

RESULTS

Providing 9vHPV to females compared with 4vHPV for females (assuming 4vHPV for males in both scenarios) was cost-saving regardless of whether or not cross-protection for 4vHPV was assumed. The cost per quality-adjusted life year (QALY) gained by 9vHPV for both sexes (compared with 4vHPV for both sexes) was < $0 (cost-saving) when assuming no cross-protection for 4vHPV and $8,600 when assuming cross-protection for 4vHPV.

CONCLUSIONS

Compared with a vaccination program of 4vHPV for both sexes, a vaccination program of 9vHPV for both sexes can improve health outcomes and can be cost-saving.

摘要

引言

本研究的目的是评估九价人乳头瘤病毒疫苗(9vHPV)与四价人乳头瘤病毒疫苗(4vHPV)相比的增量成本和效益。与4vHPV一样,9vHPV可预防人乳头瘤病毒6、11、16和18型。9vHPV还可预防另外5种人乳头瘤病毒类型,即31、33、45、52和58型。

方法

我们对先前发表的4vHPV影响和成本效益模型进行了调整,以纳入9vHPV中的另外5种人乳头瘤病毒类型。我们研究的疫苗策略包括:(1)男性和女性均接种4vHPV;(2)女性接种9vHPV,男性接种4vHPV;(3)男性和女性均接种9vHPV。在基础案例中,根据可得的疫苗价格信息,9vHPV每剂比4vHPV贵13美元。

结果

无论是否假设4vHPV存在交叉保护,与女性接种4vHPV相比,女性接种9vHPV(假设两种情况下男性均接种4vHPV)都具有成本节约效益。假设4vHPV无交叉保护时,9vHPV对两性带来的每质量调整生命年(QALY)成本收益<0(成本节约);假设4vHPV有交叉保护时,该成本收益为8600美元。

结论

与两性均接种四价人乳头瘤病毒疫苗的接种计划相比,两性均接种九价人乳头瘤病毒疫苗的接种计划可改善健康结果,且具有成本节约效益。

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