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.
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.
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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