Cost-effectiveness of HPV 16, 18 vaccination in Brazil

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• 作者：Sue J. Goldie ; Jane J. Kim ; Katie Kobus ; Jeremy D. Goldhaber-Fiebert ; Joshua Salomon ; Meredith K.H. O'Shea ; F. Xavier Bosch ; Silvia de Sanjosé ; ; Eduardo L. Franco
• 关键词：HPV ; Cost-effectiveness ; Vaccination
• 刊名：Vaccine
• 出版年：2007
• 出版时间：14 August 2007
• 年：2007
• 卷：25
• 期：33
• 页码：6257-6270
• 全文大小：1200 K

文摘

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 I$ 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.