Economic evaluation of human papillomavirus vaccination in the United Kingdom
Economic evaluation of human papillomavirus vaccination in the United Kingdom
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DOI：
10.1136/bmj.a769
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发表时间：
2008-08-09
影响因子：
105.7
通讯作者：
Edmunds, W. John
中科院分区：
文献类型：
--
作者：
Jit, Mark;Choi, Yoon Hong;Edmunds, W. John
目的是评估英国的12岁女学生对人类乳头状病毒感染的常规疫苗接种的成本效益。设计经济评估。设定英国。人居住的女生12岁以上。以及一系列疫苗接种选项的增量成本效益比。 80％覆盖范围为80％的四价疫苗可能会在愿意支付30磅的阈值（（SIC）37 700; 59 163 $ 59 163）的情况下，每QALY获得的成本效益，如果疫苗的平均保护持续时间超过10年。在18岁以下的女孩中实施追赶运动可能是具有成本效益的。男孩的疫苗接种不太可能具有成本效益。针对人类乳头瘤病毒16和18的二价疫苗，每剂量减轻13-磅21磅（取决于疫苗保护的持续时间）的成本较小，可能与四相疫苗一样有效，尽管在健康益处方面较低。结论在12岁的女学生的常规疫苗接种以及最初的追赶运动至18岁的时候可能在英国具有成本效益。在许多参数和过程中，结果对不确定性是可靠的。关键的影响变量是疫苗保护的持续时间。
Objective To assess the cost effectiveness of routine vaccination of 12 year old schoolgirls against human papillomavirus infection in the United Kingdom.Design Economic evaluation.Setting UK.Population Schoolgirls aged 12 or older.Main outcome measures Costs, quality adjusted life years (QALYs), and incremental cost effectiveness ratios for a range of vaccination options.Results Vaccinating 12 year old schoolgirls with a quadrivalent vaccine at 80% coverage is likely to be cost effective at a willingness to pay threshold of 30 pound 000 ((sic)37 700; $59 163) per QALY gained, if the average duration of protection from the vaccine is more than 10 years. Implementing a catch-up campaign of girls up to age 18 is likely to be cost effective. Vaccination of boys is unlikely to be cost effective. A bivalent vaccine with the same efficacy against human papillomavirus types 16 and 18 costing 13- pound 21 pound less per dose (depending on the duration of vaccine protection) may be as cost effective as the quadrivalent vaccine although less effective in terms of health benefits.Conclusions Routine vaccination of 12 year old schoolgirls combined with an initial catch-up campaign up to age 18 is likely to be cost effective in the UK. The results are robust to uncertainty in many parameters and processes. A key influential variable is the duration of vaccine protection.