Department of Community Health Sciences, Vaccine and Drug Evaluation Centre, University of Manitoba, 337-750 McDermot Avenue, Winnipeg, MB, R3E 0T5, Canada.
Appl Health Econ Health Policy. 2018 Apr;16(2):195-205. doi: 10.1007/s40258-017-0367-1.
The total direct cost of screening and treating all human papillomavirus-related diseases (HPV-RD) has not been measured in a single study. Accurate cost estimates are needed to inform decisions on intervention priorities and evaluate the cost-effectiveness of existing programs. We used province-wide clinical, administrative, and accounting databases to measure direct medical costs of HPV infection in Manitoba (Canada).
All persons 9 years or older with health insurance coverage in Manitoba between April 2000 and March 2015 were eligible. We identified all persons with an incident HPV-RD and aggregated all medical costs (in 2014 Canadian dollars) related to that condition, including prescription drugs, diagnostic procedures, in-hospital and outpatient treatment, and physician visits.
We found that the median cost of treating a case of anogenital warts was $130. An episode of cervical dysplasia had a median cost of $220, compared to $1300 for an episode of cervical carcinoma in situ. The cost of treating HPV-related invasive cancer varied from $15,000 for cervical cancer to $33,000 for oral cavity cancer. Overall, 80% ($145 million) of the total cost was attributable to HPV infection. Cervical screening and follow-up accounted for $96 million (66%) of all costs and this cost component has declined following the introduction of new screening guidelines.
Overall, the average direct medical cost of HPV infection was $720 per newborn. The economic burden of HPV remains significant, although changes in cervical screening guidelines, prompted by the introduction of a public HPV vaccine program, appear to have promoted a promising trend towards lower costs.
尚未有研究单独测量筛查和治疗所有人乳头瘤病毒相关疾病（HPV-RD）的总直接成本。需要准确的成本估算来为干预优先事项提供信息，并评估现有方案的成本效益。我们使用全省范围的临床、行政和会计数据库来衡量曼尼托巴省（加拿大）HPV 感染的直接医疗成本。
所有在 2000 年 4 月至 2015 年 3 月期间有医疗保险覆盖的 9 岁及以上的人都有资格参加。我们确定了所有患有 HPV-RD 的新发病例，并汇总了与该疾病相关的所有医疗费用（以 2014 年加元计算），包括处方药、诊断程序、住院和门诊治疗以及医生就诊。
我们发现治疗生殖器疣的平均费用为 130 加元。宫颈发育不良的平均费用为 220 加元，而宫颈原位癌的平均费用为 1300 加元。治疗 HPV 相关浸润性癌症的费用因癌症部位而异，从宫颈癌的 15000 加元到口腔癌的 33000 加元不等。总的来说，80%（1.45 亿加元）的总成本归因于 HPV 感染。宫颈筛查和随访占所有费用的 9600 万加元（66%），并且在引入新的筛查指南后，该成本部分有所下降。
总的来说，HPV 感染的平均直接医疗成本为每名新生儿 720 加元。HPV 的经济负担仍然很大，尽管由于引入了公共 HPV 疫苗计划，宫颈筛查指南的变化似乎呈现出降低成本的良好趋势。
