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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: vaccine,human papillomavirus,cost-utility,Korea
- چکیده:
- چکیده انگلیسی: Background: Cervical cancer is caused by the human papillomavirus and is a leading cause of cancer death among
young Korean women. Current screening programmes could benefit from the addition of HPV vaccination into their
schedule to help reduce disease burden. Two-dose vaccination schedules targeting HPV types 16 and 18, which are
responsible for most cervical cancer cases, have recently been approved. Of the two available vaccines, AS04-adjuvanted
HPV16/18 vaccine (AS04-HPV16/18v) provides greater protection against non-vaccine oncogenic HPV, while
HPV-6/11/16/18 vaccine (4vHPVv) provides protection against genital warts. Methods: The health and economic
consequences of introducing a two-dose HPV vaccination programme in 12-year-old girls together with screening were
assessed in the Korean healthcare setting using a previously-published Markov model. Results: Compared with screening
alone, AS04-HPV16/18v was cost-effective (incremental cost-effectiveness ratio below and within the Korean Won
[KRW] 20-30 million treshold). When comparing the two vaccines, at 3% discount rate, AS04-HPV16/18v dominated
4vHPVv (i.e., provided 174 more quality-adjusted life-years (QALYs), 304 more life-years (LYs) and cost-savings of
KRW 980 million). At a 5% discount rate, AS04-HPV16/18v provided comparable QALYs (albeit 5 fewer), 105 more
LYs and cost-savings of KRW 292 million compared with 4vHPVv. Results were particularly sensitive to the discount
rate used, as the health benefits of preventing cervical cancer are observed much later than those of preventing genital
warts. Conclusion: For the Korean setting, HPV vaccination with a two-dose schedule is a cost-effective option, and
AS04-HPV16/18v is likely to offer better health outcomes at a cost-saving compared with 4vHPVv.- انتشار مقاله: 20-01-1397
- نویسندگان: Hyunju Lee,Sooyoung Hur,Hyeongap Jang,I-Heng Lee,Woo-Yun Sohn,Georges Van Kriekinge,Byoung-Gie Kim
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Malaysia,Cost-Effectiveness,human papillomavirus,Two-dose schedule
- چکیده:
- چکیده انگلیسی: Purpose: To comparatively evaluate the results of a 2-dose human papillomavirus (HPV) vaccination programme
with the AS04-adjuvanted HPV16/18 vaccine (AS04-HPV-16/18v) or HPV-6/11/16/18 vaccine (4vHPVv), in addition
to cervical cancer (CC) screening, in Malaysia. Methods: A lifetime Markov model replicating the natural history of
HPV in 13-year-old girls was adapted to Malaysia to assess the impact of vaccination on pre-cancerous lesions, genital
warts and CC cases, CC deaths, quality-adjusted life years (QALYs), and costs from the perspective of the Malaysian
Ministry of Health. Vaccine effectiveness was based on efficacy and HPV type distribution. Both vaccines were assumed
to have equal efficacy against vaccine-type HPV but differed for protection against non-vaccine types. Vaccine price
parity was used and health and cost outcomes were discounted at 3%/annum. Sensitivity analyses tested the robustness
of the results. Results: The model predicted that AS04-HPV-16/18v would result in 361 fewer CC cases and 115 fewer
CC deaths than 4vHPVv, whereas 4vHPVv averted 4,241 cases of genital warts over the cohort’s lifetime. Discounted
total costs showed savings of 18.50 million Malaysian Ringgits and 246 QALYs in favour of AS04-HPV-16/18v. In
one-way sensitivity analyses, the discount rate was the most influential variable for costs and QALYs, but AS04-HPV-
16/18v remained dominant throughout. A two-way sensitivity analysis to assess the longevity of cross-protection for both
vaccines confirmed the base-case. Conclusions: In Malaysia, the use of AS04-HPV-16/18v, in addition to screening,
was modelled to be dominant over 4vHPVv, with greater estimated CC benefits and lower costs.- انتشار مقاله: 12-05-1396
- نویسندگان: Georges Van Kriekinge,Woo-Yun Sohn,Syed Mohamed Aljunid,Ruey Soon,Chee-Meng Yong,Jing Chen,I-Heng Lee
- مشاهده