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德国9价人乳头瘤病毒疫苗全民接种的公共卫生影响及成本效益评估。

An estimate of the public health impact and cost-effectiveness of universal vaccination with a 9-valent HPV vaccine in Germany.

作者信息

Largeron Nathalie, Petry Karl Ulrich, Jacob Jorge, Bianic Florence, Anger Delphine, Uhart Mathieu

机构信息

a Health Economics Department , Sanofi Pasteur MSD - Health Economics , Lyon , France.

b Klinikum Wolfsburg - OBGYN , Wolfsburg , Germany.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2017 Feb;17(1):85-98. doi: 10.1080/14737167.2016.1208087. Epub 2016 Jul 15.

DOI:10.1080/14737167.2016.1208087
PMID:27366939
Abstract

INTRODUCTION

Since 2007, the German Standing Vaccination Committee recommends HPV vaccination for girls aged 12-17 with a 2- (Cervarix®) or 4-valent (Gardasil®) vaccine. A 9-valent vaccine (Gardasil 9®) recently received a European market authorization in 2015.

METHODS

A dynamic transmission model was calibrated to the German setting and used to estimate costs and QALYs associated with vaccination strategies.

RESULTS

Compared to the current vaccination program, the 9-valent vaccine extended to boys shows further reductions of 24% in the incidence of cervical cancer, 30% and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new strategy is associated with an ICER of 22,987€ per QALY gained, decreasing to 329€ when considering the vaccine switch for girls-only.

CONCLUSION

Universal vaccination with the 9-valent vaccine can yield significant health benefits when compared to the current program.

摘要

引言

自2007年起,德国常设疫苗接种委员会建议为12至17岁的女孩接种二价(希瑞适®)或四价(加德西®)人乳头瘤病毒(HPV)疫苗。九价疫苗(佳达修9®)于2015年获得欧洲市场授权。

方法

采用动态传播模型对德国的情况进行校准,并用于估计与疫苗接种策略相关的成本和质量调整生命年(QALY)。

结果

与当前的疫苗接种计划相比,将九价疫苗接种范围扩大至男孩后,宫颈癌发病率进一步降低24%,男性和女性肛门癌发病率分别降低30%和14%,100年后可避免超过100万例尖锐湿疣病例。新策略的增量成本效果比(ICER)为每获得一个QALY 22,987欧元,若仅考虑为女孩更换疫苗,则降至329欧元。

结论

与当前计划相比,九价疫苗全民接种可带来显著的健康益处。

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