Health Economic and Decision Sciences, Merck & Co, Inc, Rahway, NJ, USA.
MSD, Haarlem, the Netherlands.
Expert Rev Vaccines. 2024 Jan-Dec;23(1):312-323. doi: 10.1080/14760584.2024.2322543. Epub 2024 Mar 1.
A bivalent human papillomavirus vaccine (2vHPV) is currently used in the Netherlands; a nonavalent vaccine (9vHPV) is also licensed.
We compared the public health and economic benefits of 2vHPV- and 9vHPV-based vaccination strategies in the Netherlands over 100 years using a validated deterministic dynamic transmission metapopulation model.
Compared to 2vHPV, the 9vHPV strategy averted an additional 3,245 cases of and 825 deaths from 9vHPV-strain-attributable cancers, 4,247 cases of and 190 deaths from recurrent respiratory papillomatosis (RRP), and 1,009,637 cases of anogenital warts (AGWs), with an incremental cost-effectiveness ratio (ICER) of €4,975 per quality-adjusted life year (QALY) gained. The ICER increased in a scenario with increased HPV vaccination coverage rates and was relatively robust to one-way deterministic sensitivity analyses, with variation in the disease utility parameter having the most impact. When catch-up vaccination for individuals ≤26 years of age was added to the model, vaccinating with 9vHPV averted additional cancers and AGWs compared to 2vHPV vaccination.
Our analyses predict that transitioning from a 2vHPV- to a 9vHPV-based vaccination strategy would be cost-effective in the Netherlands.
目前荷兰使用的是人乳头瘤病毒（HPV）二价疫苗（2vHPV）；也有九价疫苗（9vHPV）获得许可。
我们使用经过验证的确定性动态传播集合模型，比较了荷兰在 100 年内使用 2vHPV 和 9vHPV 疫苗接种策略的公共卫生和经济效益。
与 2vHPV 相比，9vHPV 策略避免了 3245 例由 9vHPV 型引起的癌症病例和 825 例死亡，4247 例复发性呼吸道乳头瘤病（RRP）病例和 190 例死亡，1009637 例生殖器疣（AGWs）病例，增量成本效益比（ICER）为每获得一个质量调整生命年（QALY）增加 4975 欧元。在 HPV 疫苗接种覆盖率增加的情况下，ICER 会增加，并且对单向确定性敏感性分析具有相对稳健性，疾病效用参数的变化影响最大。当在模型中加入对≤26 岁个体的补种疫苗时，与 2vHPV 疫苗接种相比，9vHPV 疫苗接种可预防更多癌症和 AGWs。
我们的分析预测，从 2vHPV 到 9vHPV 疫苗接种策略的转变将在荷兰具有成本效益。
