The cost-effectiveness of male HPV vaccination in the United States
The cost-effectiveness of male HPV vaccination in the United States
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DOI：
10.1016/j.vaccine.2011.07.096
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发表时间：
2011-10-26
期刊：
影响因子：
5.5
通讯作者：
Markowitz, Lauri E.
中科院分区：
文献类型：
--
作者：
Chesson, Harrell W.;Ekwueme, Donatus U.;Markowitz, Lauri E.
简介：本研究的目的是估计的成本效益增加人乳头瘤病毒（HPV）疫苗接种的12岁的男性，只有女性的疫苗接种计划，年龄在12-26 years in the United States.Methods：我们使用了一个简化的模型，HPV的传播，以估计减少HPV相关疾病的健康和经济负担的男性和女性的HPV疫苗接种的结果。HPV相关健康结果的发病率、每例成本和生活质量影响的估计基于文献。HPV相关的结果包括：宫颈上皮内瘤变（CIN），生殖器疣，青少年发病的复发性呼吸道乳头状瘤病（RRP）：和宫颈，阴道，外阴，肛门，口咽，阴茎cancer.Results：男性疫苗接种的成本效益取决于女性的疫苗覆盖率。当分析中包括所有HPV相关结果时，通过将男性疫苗接种添加到仅女性疫苗接种计划中获得的每质量调整生命年（QALY）增量成本在较低女性覆盖率情景中为23，600美元（12岁时覆盖率为20%），在较高女性覆盖率情景中为184，300美元（12岁时覆盖率为75%）。与增加女性疫苗接种覆盖率的战略相比，男性疫苗接种的成本效益似乎不太有利。例如，我们发现，增加12岁女孩的接种率比增加男性疫苗接种率更具成本效益，即使增加女性疫苗接种策略导致每增加一名女孩接种疫苗的计划成本为350美元。12岁男性的HPV疫苗接种可能具有成本效益，特别是如果女性HPV疫苗接种覆盖率低，并且HPV疫苗接种的所有潜在健康益处都包括在分析中。然而，增加女性覆盖率可能是比男性疫苗接种更有效的策略，以减少人口中HPV的整体健康负担。爱思唯尔有限公司出版
Introduction: The objective of this study was to estimate the cost-effectiveness of adding human papillomavirus (HPV) vaccination of 12-year-old males to a female-only vaccination program for ages 12-26 years in the United States.Methods: We used a simplified model of HPV transmission to estimate the reduction in the health and economic burden of HPV-associated diseases in males and females as a result of HPV vaccination. Estimates of the incidence, cost-per-case, and quality-of-life impact of HPV-associated health outcomes were based on the literature. The HPV-associated outcomes included were: cervical intraepithelial neoplasia (CIN); genital warts; juvenile-onset recurrent respiratory papillomatosis (RRP): and cervical, vaginal, vulvar, anal, oropharyngeal, and penile cancers.Results: The cost-effectiveness of male vaccination depended on vaccine coverage of females. When including all HPV-associated outcomes in the analysis, the incremental cost per quality-adjusted life year (QALY) gained by adding male vaccination to a female-only vaccination program was $23,600 in the lower female coverage scenario (20% coverage at age 12 years) and $184,300 in the higher female coverage scenario (75% coverage at age 12 years). The cost-effectiveness of male vaccination appeared less favorable when compared to a strategy of increased female vaccination coverage. For example, we found that increasing coverage of 12-year-old girls would be more cost-effective than adding male vaccination even if the increased female vaccination strategy incurred program costs of $350 per additional girl vaccinated.Conclusions: HPV vaccination of 12-year-old males might potentially be cost-effective, particularly if female HPV vaccination coverage is low and if all potential health benefits of HPV vaccination are included in the analysis. However, increasing female coverage could be a more efficient strategy than male vaccination for reducing the overall health burden of HPV in the population. Published by Elsevier Ltd.