Jiang Y, Ni Weiyi, Wu Jing
School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China.
Department of Pharmaceutical and Health Economics, University of Southern California, Los Angeles, California, USA.
BMJ Open. 2019 Nov 24;9(11):e031186. doi: 10.1136/bmjopen-2019-031186.
To evaluate the cost-effectiveness of the 9-valent human papillomavirus (HPV) vaccine for the prevention of cervical cancer in China.
Health economic modelling using the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model populated with China-specific data.
Individual cervical cancer prevention in China using the 9-valent HPV vaccine from the perspective of private sector purchasers in relation to receiving other HPV vaccines and not receiving vaccination for 16-year-old girls in China who had not been previously infected with HPV.
Not applicable.
Vaccination using the 9-valent, the quadrivalent and the bivalent vaccines.
Incremental costs per disability-adjusted life year (DALY) prevented.
In the base case, the incremental costs per DALY prevented were, respectively, US$35 000 and US$50 455 compared with the quadrivalent and the bivalent vaccines, both of which were above the cost-effective threshold of US$25 920/DALY prevented. To be cost-effective in these comparisons, the 9-valent vaccine should be priced at $550 and $450 for the full doses, respectively. To be highly cost-effective, the price thresholds were $435 and $335. The incremental costs per DALY prevented in relation to no vaccination was US$23 012, making the 9-valent vaccine marginally cost-effective. The results were robust in most one-way sensitivity analyses including changing vaccination age to 13 and 26 years.
At the current price, the 9-valent HPV vaccine is not cost-effective compared with the quadrivalent and the bivalent vaccines for young girls in China who had not been previously infected with HPV. Policymakers and clinicians should keep potential vaccine recipients informed about the economic profile of the 9-valent vaccine and carefully consider expanding its use in China at the current price.
评估九价人乳头瘤病毒（HPV）疫苗在中国预防宫颈癌的成本效益。
采用人乳头瘤病毒建模与经济学快速接口（PRIME）模型并填充中国特定数据进行健康经济建模。
从私营部门购买者的角度出发，针对中国未感染过HPV的16岁女孩，使用九价HPV疫苗进行个体宫颈癌预防，并与接种其他HPV疫苗及不接种疫苗的情况进行比较。
不适用。
使用九价、四价和二价疫苗进行接种。
每预防一个伤残调整生命年（DALY）的增量成本。
在基础案例中，与四价和二价疫苗相比，每预防一个DALY的增量成本分别为35,000美元和50,455美元，均高于每预防一个DALY成本效益阈值25,920美元。在这些比较中，要具有成本效益，九价疫苗全剂量的定价应分别为550美元和450美元。要具有高成本效益，价格阈值分别为435美元和335美元。与不接种疫苗相比，每预防一个DALY的增量成本为23,012美元，这使得九价疫苗勉强具有成本效益。在大多数单向敏感性分析中，包括将接种年龄改为13岁和26岁，结果都是稳健的。
对于中国未感染过HPV的年轻女孩，按当前价格，九价HPV疫苗与四价和二价疫苗相比不具有成本效益。政策制定者和临床医生应让潜在的疫苗接种者了解九价疫苗的经济情况，并谨慎考虑按当前价格在中国扩大其使用范围。
