Cost-effectiveness of HPV 16, 18 vaccination in Brazil
Cost-effectiveness of HPV 16, 18 vaccination in Brazil
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DOI：
10.1016/j.vaccine.2007.05.058
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发表时间：
2007-08-14
期刊：
影响因子：
5.5
通讯作者：
Franco, Eduardo L.
中科院分区：
文献类型：
--
作者：
Goldie, Sue J.;Kim, Jane J.;Franco, Eduardo L.
我们使用一个经验校准的模型来估计巴西宫颈癌预防的成本效益，巴西是一个宫颈癌负担高的国家。假设覆盖率为70%，青春期女孩接种HPV 16、18疫苗预计将使患癌症的终生风险降低约42.7%（范围33.2-53.5%）；根据筛查试验的不同，每一生筛查三次预计可将风险降低21.9-30.7%，接种疫苗和筛查相结合的方法预计可将癌症风险平均降低60.8%（范围52.8-70.1%）。在巴西;如果每位接种疫苗的妇女的费用低于25美元，即每剂费用约为1美元，那么在12岁之前接种疫苗，然后在35岁至45岁之间一生进行三次筛查，以该国的人均国内生产总值作为成本效益阈值，将被认为是非常具有成本效益的。假设覆盖率为70%，这一策略预计将在5年期间预防大约10万例浸润性宫颈癌。在没有援助的情况下，被确定为具有成本效益的疫苗接种战略在社会经济状况与巴西相似的国家可能负担不起；这些结果可以通过确定最优先和最有希望的卫生投资，为全球社会提供指导。(c) 2007 Elsevier Ltd.版权所有。
We use an empirically calibrated model to estimate the cost-effectiveness of cervical cancer prevention in Brazil, a country with a high cervical cancer burden. Assuming 70% coverage, HPV 16, 18 vaccination of adolescent girls is expected to reduce the lifetime risk of cancer by approximately 42.7% (range, 33.2-53.5%); screening three times per lifetime is expected to reduce risk by 21.9-30.7% depending on the screening test, and a combined approach of vaccination and screening is expected to reduce cancer risk by a mean of 60.8% (range, 52.8-70.1%). In Brazil; provided the cost per vaccinated woman is less than I$ 25, implying a per dose cost of approximately 1$ 5, vaccination before age 12, followed by screening three times per lifetime between ages 35 and 45, would be considered very cost-effective using the country's per capita gross domestic product as a cost-effectiveness threshold. Assuming a coverage rate of 70%, this strategy would be expected to prevent approximately 100,000 cases of invasive cervical cancer over a 5-year period. Vaccination strategies identified as cost-effective may be unaffordable in countries with similar socioeconomic profiles as Brazil without assistance; these results can provide guidance to the global community by identifying health investments of highest priority and with the greatest promise. (c) 2007 Elsevier Ltd. All rights reserved.