The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model
The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model
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DOI：
10.1080/21645515.2016.1140288
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发表时间：
2016-01-01
影响因子：
4.8
通讯作者：
Saraiya, Mona
中科院分区：
文献类型：
--
作者：
Chesson, Harrell W.;Markowitz, Lauri E.;Saraiya, Mona
简介：本研究的目的是评估9价HPV疫苗（9vHPV）与四价HPV疫苗（4vHPV）相比的增量成本和效益。与4vHPV一样，9vHPV可预防HPV 6、11、16和18型。9vHPV还可以预防另外5种HPV类型31，33，45，52和58。方法：我们采用了先前发表的4vHPV的影响和成本效益模型，以包括9vHPV中的5种额外HPV类型。我们检查的疫苗策略是（1）男性和女性的4vHPV;（2）女性的9vHPV和男性的4vHPV;（3）男性和女性的9vHPV。根据现有的疫苗价格信息，在基础病例中，9vHPV每剂的成本比4vHPV高13美元。结果如下：无论是否假设4vHPV交叉保护，向女性提供9vHPV与向女性提供4vHPV（在两种情况下假设男性为4vHPV）相比都可以节省成本。当假设4vHPV没有交叉保护时，9vHPV对两性（与4vHPV对两性相比）获得的每质量调整生命年（QALY）成本<0美元（节省成本），当假设4vHPV交叉保护时为8，600美元。结论：与针对男性和女性的4vHPV疫苗接种计划相比，针对男性和女性的9vHPV疫苗接种计划可以改善健康结果，并且可以节省成本。
Introduction: The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58. Methods: We adapted a previously published model of the impact and cost-effectiveness of 4vHPV to include the 5 additional HPV types in 9vHPV. The vaccine strategies we examined were (1) 4vHPV for males and females; (2) 9vHPV for females and 4vHPV for males; and (3) 9vHPV for males and females. In the base case, 9vHPV cost $13 more per dose than 4vHPV, based on available vaccine price information. Results: Providing 9vHPV to females compared with 4vHPV for females (assuming 4vHPV for males in both scenarios) was cost-saving regardless of whether or not cross-protection for 4vHPV was assumed. The cost per quality-adjusted life year (QALY) gained by 9vHPV for both sexes (compared with 4vHPV for both sexes) was < $0 (cost-saving) when assuming no cross-protection for 4vHPV and $8,600 when assuming cross-protection for 4vHPV. Conclusions: Compared with a vaccination program of 4vHPV for both sexes, a vaccination program of 9vHPV for both sexes can improve health outcomes and can be cost-saving.