Biostatistics & Research Decision Sciences, Merck & Co., Inc, Rahway, NJ, USA.
MSD K.K, Tokyo, Japan.
J Med Econ. 2023 Jan-Dec;26(1):1546-1554. doi: 10.1080/13696998.2023.2282912. Epub 2023 Nov 27.
To assess the public health impact and cost effectiveness of gender-neutral vaccination (GNV) versus female-only vaccination (FOV) with human papillomavirus (HPV) vaccination in Japan.
We modeled the public health impact and cost effectiveness of GNV versus FOV to prevent HPV-associated diseases in Japan over the next 100 years. We used one-way sensitivity analyses to examine the impact of varying key model input parameters and conducted scenario analyses to explore the effects of varying the vaccination coverage rate (VCR) of each cohort.
In the base-case analysis, GNV averted additional cancer cases (17,228 female/6,033 male) and deaths (1,892 female/1,849 male) compared to FOV. When all HPV-associated diseases were considered, GNV had an incremental cost-effectiveness ratio of ¥4,732,320 (US$35,987)/quality-adjusted life year gained compared to FOV. The model was most sensitive to the discount rate and the disutility associated with HPV-related diseases. GNV had greater relative public health benefits when the female VCR was lower and was cost effective at a female VCR of 30%.
Immediate implementation of GNV would reduce the disease burden and mortality associated with HPV in Japan, and would be cost effective compared to FOV if the female VCR remains low (30%).
评估在日本，对人乳头瘤病毒（HPV）疫苗接种采用性别中立疫苗接种（GNV）与女性专用疫苗接种（FOV），对公共卫生的影响和成本效益。
我们建立了模型，以评估 GNV 与 FOV 对预防日本未来 100 年内 HPV 相关疾病的公共卫生影响和成本效益。我们使用单因素敏感性分析来检查各种关键模型输入参数的影响，并进行情景分析以探讨改变每个队列的疫苗接种覆盖率（VCR）的影响。
在基本分析中，与 FOV 相比，GNV 避免了更多的癌症病例（17228 例女性/6033 例男性）和死亡（1892 例女性/1849 例男性）。当考虑所有与 HPV 相关的疾病时，GNV 的增量成本效益比为每获得一个质量调整生命年（QALY）需花费 ¥4732320（35987 美元），优于 FOV。该模型对贴现率和 HPV 相关疾病的不舒适相关的参数最敏感。当女性 VCR 较低时，GNV 具有更大的公共卫生效益，并且在女性 VCR 为 30%时具有成本效益。
立即实施 GNV 将减少日本 HPV 相关疾病负担和死亡率，与 FOV 相比，如果女性 VCR 保持较低水平（30%），则具有成本效益。
