Wednesday, 16th of March 2016 |
This article is of great pertinence to China, but its conclusions should not be generalized to other geographical settings. Countries need to look at sexual debut data from DHS or other sources, as well as age-specific school enrolment rates, before setting ages for HPV vaccination. In addition, any HPV introduction campaign may have an age range different from that for post-introduction routine HPV immunization.
Last but not least, school vaccinations work best where school health programs are well established.
BMC Cancer. 2016 Feb 26;16(1):164. doi: 10.1186/s12885-016-2207-3.
Effect of vaccination age on cost-effectiveness of human papillomavirus vaccination against cervical cancer in China
Liu YJ1,2, Zhang Q1, Hu SY3, Zhao FH1.
Abstract below; full text is at http://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2207-3
BACKGROUND:
The cost-effectiveness of human papillomavirus (HPV) vaccination in women pre-sexual debut has been demonstrated in many countries. This study aimed to estimate the cost-effectiveness of a 3-dose bivalent HPV vaccination at ages 12 to 55 year in both rural and urban settings in China.
METHODS:
The Markov cohort model simulated the natural history of HPV infection and included the effect of screening and HPV vaccination over the lifetime of a 100,000 female cohort. Transition probabilities and utilities were obtained from published literature. Cost data were estimated by Delphi panel using healthcare payers´ perspective. Vaccine cost was assumed Hong Kong listed price. Vaccine efficacy (VE) was based on the PATRICIA trial data assuming VE irrespective of HPV type at all ages on incident HPV. Costs and outcomes were discounted at 3 %. Cervical cancer cases and incremental cost-effectiveness ratio (ICER) for vaccination and screening compared with screening alone were estimated for each vaccination age. Reduced VE in women post-sexual debut were investigated in scenario analyses.
RESULTS:
With 70 % vaccination coverage, a reduction of cancer cases varying from 585 to 33 in rural and 691 to 32 in urban were estimated at ages 12 to 55, respectively. The discounted ICERs of vaccination at any age under 23 years in rural and any age under 25 years in urban were lower than the current threshold. Scenario analyses with lower VE post-sexual debut confirmed the results with age 20 in rural and 21 in urban had consistent lower ICERs. The more ´catch-up´ cohorts vaccinated at the start of a program, the more cancer lesions are avoided in the long-term.
CONCLUSIONS:
Vaccination at any age under 23 years old in rural and any age under 25 years old in urban were cost-effective. Catch-up to the age of 25 years in rural and urban could still be cost-effective.
Similar articles
Are three drugs for malaria better than two?
Friday, 24th of April 2020 |
Public health Interventions and epidemic intensity during the 1918 influenza pandemic
Thursday, 16th of April 2020 |
Chloroquine and hydroxychloroquine as available weapons to fight COVID-19
Tuesday, 17th of March 2020 |
Using models to shape measles control and elimination strategies in low- and middle-income countries: A review of recent applications
Monday, 17th of February 2020 |
Immunization Agenda 2030
Tuesday, 11th of February 2020 |
41165552 |
www.measlesinitiative.org www.technet21.org www.polioeradication.org www.globalhealthlearning.org www.who.int/bulletin allianceformalariaprevention.com www.malariaworld.org http://www.panafrican-med-journal.com/ |