Cost-effectiveness of HPV vaccination in 195 countries: A meta-regression analysis.
Cost-effectiveness of HPV vaccination in 195 countries: A meta-regression analysis.
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DOI：
10.1371/journal.pone.0260808
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Murray CJL
中科院分区：
文献类型：
--
作者：
Rosettie KL;Joffe JN;Sparks GW;Aravkin A;Chen S;Compton K;Ewald SB;Mathew EB;Michael D;Pedroza Velandia P;Miller-Petrie MB;Stafford L;Zheng P;Weaver MR;Murray CJL
成本效益分析（CEA）是比较卫生干预措施的成本和健康结果的一种众所周知但资源密集的方法。为了建立在现有证据的基础上，研究人员正在开发跨环境转移CEA的方法；以前的方法没有使用所有可用的结果，也没有量化不同设置之间的差异。我们对已发表的人乳头瘤病毒（HPV）疫苗接种cea进行了荟萃回归分析，以量化国家、干预和方法层面因素的影响，并预测195个国家HPV疫苗接种的增量成本-效果比（ICERs）。我们使用了塔夫茨大学成本-效果分析（CEA）登记处和全球健康CEA登记处的75项研究中报告的613例ICERs，并提取了额外的1215项单向敏感性分析。采用五阶段混合效应元回归框架预测国家特定ICERs。使用逻辑回归模型预测每个国家HPV疫苗接种节省成本的概率。这两个模型的协变量包括方法和干预特征，以及每个国家的宫颈癌负担和人均国内生产总值。ICERs与疫苗成本呈正相关，与宫颈癌负担负相关。全球HPV疫苗接种的平均预测ICER为2017年每避免DALY 4217美元（95%不确定区间（UI）： 773 - 13448美元），64个国家的ICER低于每避免DALY 800美元。撒哈拉以南非洲和南亚的预测ICERs最低，46个国家的人口加权平均ICERs为每避免DALY 706美元（95% UI: 130 - 2245美元），5个国家的人口加权平均ICERs为每避免DALY 489美元（95% UI: 90 - 1557美元）。可以对CEA进行meta回归分析，其中使用单向敏感性分析来量化干预和方法水平上因素的影响。基于所有已发表的结果，我们的预测支持引入和扩大HPV疫苗接种，特别是在有资格获得全球疫苗免疫联盟、疫苗联盟和泛美卫生组织补贴疫苗的国家。
Cost-effectiveness analysis (CEA) is a well-known, but resource intensive, method for comparing the costs and health outcomes of health interventions. To build on available evidence, researchers are developing methods to transfer CEA across settings; previous methods do not use all available results nor quantify differences across settings. We conducted a meta-regression analysis of published CEAs of human papillomavirus (HPV) vaccination to quantify the effects of factors at the country, intervention, and method-level, and predict incremental cost-effectiveness ratios (ICERs) for HPV vaccination in 195 countries. We used 613 ICERs reported in 75 studies from the Tufts University’s Cost-Effectiveness Analysis (CEA) Registry and the Global Health CEA Registry, and extracted an additional 1,215 one-way sensitivity analyses. A five-stage, mixed-effects meta-regression framework was used to predict country-specific ICERs. The probability that HPV vaccination is cost-saving in each country was predicted using a logistic regression model. Covariates for both models included methods and intervention characteristics, and each country’s cervical cancer burden and gross domestic product per capita. ICERs are positively related to vaccine cost, and negatively related to cervical cancer burden. The mean predicted ICER for HPV vaccination is 2017 US$4,217 per DALY averted (95% uncertainty interval (UI): US$773–13,448) globally, and below US$800 per DALY averted in 64 countries. Predicted ICERs are lowest in Sub-Saharan Africa and South Asia, with a population-weighted mean ICER across 46 countries of US$706 per DALY averted (95% UI: $130–2,245), and across five countries of US$489 per DALY averted (95% UI: $90–1,557), respectively. Meta-regression analyses can be conducted on CEA, where one-way sensitivity analyses are used to quantify the effects of factors at the intervention and method-level. Building on all published results, our predictions support introducing and expanding HPV vaccination, especially in countries that are eligible for subsidized vaccines from GAVI, the Vaccine Alliance, and Pan American Health Organization.
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DOI：
10.1016/s0140-6736(17)32906-9
发表时间：
2018-03-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
Jamison DT;Alwan A;Mock CN;Nugent R;Watkins D;Adeyi O;Anand S;Atun R;Bertozzi S;Bhutta Z;Binagwaho A;Black R;Blecher M;Bloom BR;Brouwer E;Bundy DAP;Chisholm D;Cieza A;Cullen M;Danforth K;de Silva N;Debas HT;Donkor P;Dua T;Fleming KA;Gallivan M;Garcia PJ;Gawande A;Gaziano T;Gelband H;Glass R;Glassman A;Gray G;Habte D;Holmes KK;Horton S;Hutton G;Jha P;Knaul FM;Kobusingye O;Krakauer EL;Kruk ME;Lachmann P;Laxminarayan R;Levin C;Looi LM;Madhav N;Mahmoud A;Mbanya JC;Measham A;Medina-Mora ME;Medlin C;Mills A;Mills JA;Montoya J;Norheim O;Olson Z;Omokhodion F;Oppenheim B;Ord T;Patel V;Patton GC;Peabody J;Prabhakaran D;Qi J;Reynolds T;Ruacan S;Sankaranarayanan R;Sepúlveda J;Skolnik R;Smith KR;Temmerman M;Tollman S;Verguet S;Walker DG;Walker N;Wu Y;Zhao K
通讯作者：
Zhao K
影响因子：
34.3
作者：
Salomon, Joshua A.;Haagsma, Juanita A.;Vos, Theo
通讯作者：
Vos, Theo
影响因子：
4.4
作者：
Neumann, Peter J.;Fang, Chi-Hui;Cohen, Joshua T.
通讯作者：
Cohen, Joshua T.
影响因子：
15.8
作者：
Ioannidis, JPA
通讯作者：
Ioannidis, JPA
影响因子：
11.1
作者：
Marseille E;Larson B;Kazi DS;Kahn JG;Rosen S
通讯作者：
Rosen S