Institute of Child Health and Human Development, University of the Philippines Manila-National Institutes of Health, Manila, Philippines; Department of Obstetrics and Gynecology, University of the Philippines Manila-Philippine General Hospital, Philippines.
Institute of Child Health and Human Development, University of the Philippines Manila-National Institutes of Health, Manila, Philippines.
Vaccine. 2022 Jun 15;40(27):3802-3811. doi: 10.1016/j.vaccine.2022.05.025. Epub 2022 May 20.
Cervical cancer is the second most common cancer among women in the Philippines. Human papillomavirus (HPV) vaccination provides protection from the most common cancer-causing HPV types. This analysis used a proportionate outcomes model to estimate the potential cost-effectiveness of four different HPV vaccine products-Cervarix™, Cecolin®, GARDASIL®, and GARDASIL®9-for routine HPV vaccination of 10 cohorts of 9-year-old girls from the government and societal perspectives. Model parameters included cervical cancer burden, healthcare and program costs, vaccine efficacy with and without potential cross-protection, and vaccination coverage. Univariate and probabilistic sensitivity analyses evaluated the impact of uncertainty on model results. Compared to no vaccination, HPV programs with Cecolin®, Cervarix™, and GARDASIL® are projected to be cost-effective at US$1,210, US$1,300, and US$2,043 per DALY averted, respectively, from the government perspective, and at US$173, US$263, and US$1,006 per DALY averted, respectively, from the societal perspective when cross-protection was considered. When direct comparisons were made across vaccines, GARDASIL® was dominated by Cervarix™ and Cecolin®. In a scenario where cross-protection was not considered, results were similar except that Cervarix™ and GARDASIL® were both dominated by Cecolin®. GARDASIL®9 was not cost-effective under any of the modeled scenarios.
在菲律宾，宫颈癌是女性中第二大常见癌症。人乳头瘤病毒（HPV）疫苗接种可预防最常见的致癌 HPV 类型。本分析使用比例结果模型，从政府和社会角度估计了四种不同 HPV 疫苗产品（Cervarix ™、Cecolin ®、GARDASIL ®和 GARDASIL ®9）对 10 组 9 岁女孩进行常规 HPV 接种的潜在成本效益。模型参数包括宫颈癌负担、医疗保健和项目成本、疫苗有效性（包括潜在交叉保护）和疫苗接种覆盖率。单变量和概率敏感性分析评估了不确定性对模型结果的影响。与不接种疫苗相比，从政府角度看，Cecolin ®、Cervarix ™和 GARDASIL ®HPV 方案预计每避免 1 个 DALY 的成本分别为 1210 美元、1300 美元和 2043 美元，从社会角度看，每避免 1 个 DALY 的成本分别为 173 美元、263 美元和 1006 美元，当考虑交叉保护时。当对疫苗进行直接比较时，GARDASIL ®被 Cervarix ™和 Cecolin ®所超越。在不考虑交叉保护的情况下，结果相似，只是 Cervarix ™和 GARDASIL ®都被 Cecolin ®所超越。在任何建模情况下，GARDASIL ®9 都不具有成本效益。
