Public health impact and cost-effectiveness of catch-up 9-valent HPV vaccination of individuals through age 45 years in the United States.
Public health impact and cost-effectiveness of catch-up 9-valent HPV vaccination of individuals through age 45 years in the United States.
复制标题
DOI：
10.1080/21645515.2020.1852870
复制
发表时间：
2021-07-03
影响因子：
4.8
通讯作者：
Elbasha E
中科院分区：
文献类型：
--
作者：
Daniels V;Prabhu VS;Palmer C;Samant S;Kothari S;Roberts C;Elbasha E
免疫做法咨询委员会(ACIP)建议在26岁之前进行9价人乳头状瘤病毒(HPV)疫苗接种，并为27-45岁的成年人分享临床决策，而女性和男性的年龄分别为26岁和21岁(现状；2019年6月之前的建议)。这项研究评估了与现状相比，扩大追赶疫苗接种年龄至45岁(扩大追赶)对公众健康的影响和成本效益。我们使用HPV动态传播感染和疾病模型来评估疾病结果和与现状相比扩大追赶的增量成本-效果比(ICER)。从医疗保健部门的角度计算的成本(2018美元)和质量调整寿命年(QALY)每年贴现3%。使用NIS-TEN调查数据(用于敏感性分析的NHANES数据)估计历史疫苗接种覆盖率。替代情景分析包括将扩大追赶的上限限制为26年(2019年6月至2019年ACIP建议)、29年，以及进一步的5年递增。我们的结果显示，扩大追赶疫苗接种将在100年内预防37,856例癌症，314,468例宫颈上皮内瘤变-2/3，1,743,461例生殖器疣，以及10,698例死亡，成本为141,000美元/QALY。加上NHANES保险，ICER为96,000美元/QALY。与现状相比，2019年6月至2019年6月ACIP的建议还提供了公共卫生福利，ICER为11.7万美元/QALY。34岁期间扩大疫苗接种的ICER为107,000美元/QALY。在美国，将追赶疫苗接种计划扩大到45岁，预计将提供公共健康好处，并通过将追赶扩大到34岁，提高成本效益。
The Advisory Committee on Immunization Practices (ACIP) recommended catch-up 9-valent Human Papillomavirus (HPV) vaccination through age 26 years, and shared clinical decision-making for adults aged 27–45 years, compared with catch-up through age 26 years and 21 years for females and males, respectively (status quo; pre-June-2019 recommendations). This study assessed the public health impact and cost-effectiveness of expanded catch-up vaccination through age 45 years (expanded catch-up) compared with status quo. We used an HPV dynamic transmission infection and disease model to assess disease outcomes and incremental cost-effectiveness ratio (ICER) of expanded catch-up compared with status quo. Costs (2018 USD), calculated from a healthcare sector perspective, and quality-adjusted life years (QALY) were discounted at 3% annually. Historical vaccination coverage was estimated using NIS-TEEN survey data (NHANES data for sensitivity analysis). Alternative scenario analyses included restricting upper age of expanded catch-up through 26 years (June-2019 ACIP recommendation), 29 years, and further 5-year increments. Our results show expanded catch-up vaccination would prevent additional 37,856 cancers, 314,468 cervical intraepithelial neoplasia-2/3s, 1,743,461 genital warts, and 10,698 deaths compared with status quo over 100 years at cost of $141,000/QALY. With NHANES coverage, the ICER was $96,000/QALY. The June-2019 ACIP recommendation also provided public health benefits with an ICER of $117,000/QALY, compared with status quo. The ICER for expanded vaccination through age 34 years was $107,000/QALY. Expanding catch-up vaccination program through age 45 years-old in the US is expected to provide public health benefits, and cost-effectiveness improves with expanding catch-up through age 34.
登录
查看更多内容
影响因子：
5.5
作者：
Choi, Yoon Hong;Jit, Mark;Edmunds, William John
通讯作者：
Edmunds, William John
影响因子：
12.7
作者：
Flagg, Elaine W.;Torrone, Elizabeth A.
通讯作者：
Torrone, Elizabeth A.
影响因子：
2.6
作者：
German, Robert R.;Fink, Aliza K.;Yin, Daixin
通讯作者：
Yin, Daixin
DOI：
10.1086/651620
发表时间：
2010-05-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Goodman MT;Shvetsov YB;McDuffie K;Wilkens LR;Zhu X;Thompson PJ;Ning L;Killeen J;Kamemoto L;Hernandez BY
通讯作者：
Hernandez BY
影响因子：
3.1
作者：
Harper, Christopher R.;Dittus, Patricia J.;Aral, Sevgi O.
通讯作者：
Aral, Sevgi O.