肯尼亚HPV疫苗的影响,成本效益和预算影响:一个建模研究
Valerian Mwenda1, Rose Jalang'o2, Christine Miano2
1National Cancer Control Program, Ministry of Health, Nairobi, Kenya.
Vaccine
|June 9, 2023
概括
人类乳头瘤病毒 (HPV) 疫苗接种在肯尼亚非常具有成本效益,显著降低了宫癌的负担. 替代疫苗和单剂量策略以更低的成本提供更大的好处,需要政府大量资助后Gavi支持.
科学领域:
- 公共卫生 公共卫生
- 疫苗学 疫苗学 疫苗学
- 卫生经济学 卫生经济学
背景情况:
- 撒哈拉以南非洲面临着全球最高的宫癌负担.
- 肯尼亚在2019年在Gavi的支持下引入了四价HPV疫苗 (GARDASIL-4).
- 评估HPV疫苗的成本效益至关重要,因为肯尼亚从Gavi资金中过渡.
研究的目的:
- 评估肯尼亚HPV疫苗的预算影响和终身成本效益.
- 为了比较GARDASIL-4与其他HPV疫苗 (CECOLIN,CERVARIX,GARDASIL-9) 的成本效益.
- 为制定有关可持续HPV疫苗接种计划的政策决策提供信息.
主要方法:
- 为了分析,使用了一种比例结果的静态队列模型.
- 评估了10岁女孩的疫苗接种 (2020-2029年),并对11-14岁的女孩进行了追赶活动.
- 从政府和社会角度估计宫癌病例,死亡,DALY和医疗保健成本.
主要成果:
- 接种HPV疫苗可以将子宫癌的预计负担降低42-60%.
- 塞科林 (没有交叉保护) 和CERVARIX (有交叉保护) 显示出最有利的成本效益.
- 最具成本效益的疫苗在100美元的支付意愿值下,具有100%的成本效益概率.
- 一次剂量策略被发现与没有接种疫苗相比,对于Gavi支持的疫苗来说,节省了成本.
结论:
- 在肯尼亚,HPV疫苗接种是预防子宫癌的高成本有效干预措施.
- 与GARDASIL-4相比,替代性HPV疫苗可能以较低的成本提供优越的健康益处.
- 维持高疫苗接种覆盖率后Gavi需要大量的政府投资.
- 建议使用单剂量HPV疫苗接种策略,因为它具有成本效益和类似的健康益处.
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