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在中国优化宫癌预防战略:综合建模分析

Dachuang Zhou^1,2, Di Zhang^1,2, Yi Wang^1,2

¹School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China.

Cost effectiveness and resource allocation : C/E

|May 14, 2025

概括

对于中国来说,最适合的宫癌预防策略包括对35-64岁的妇女进行查,用酸视觉检查 (VIA),并用双价人乳头瘤病毒 (HPV) 疫苗接种9-14岁的女孩. 这种方法是有效的,具有成本效益和负担得起的,与消除目标保持一致.

科学领域:

公共卫生公共卫生
流行病学流行病学
卫生经济学卫生经济学

背景情况:

中国正准备推出其首个国内的9价值人类乳头瘤病毒 (HPV) 疫苗.
宫癌查技术的进步也在出现.
需要为中国确定最佳的宫癌预防策略.

研究的目的:

为中国评估和确定有效,具有成本效益和负担得起的宫癌预防策略.
评估与世界卫生组织 (WHO) 的宫癌消除目标相对应的战略.
考虑目前的预算和对干预措施的潜在降价.

主要方法:

从医疗保健系统的角度开发了一个马尔科夫模型.
该模型包括18个年龄层和9个健康状况,模拟了30年来38个预防策略.
模型参数是使用现实数据进行校准的;战略是根据世卫组织的目标,成本效益门和预算限制来评估的.

主要成果:

16个策略可以在2050年前实现宫癌消除;29个是高成本效益的;11个是负担得起的.
对35-64岁的女性进行查,用乙酸视觉检查 (VIA) 与9-14岁女孩的双价HPV疫苗接种相结合,符合所有标准.
这种最佳策略可以在2041年以2543.91美元/QALY的ICER实现淘汰,并被认为是负担得起的. 敏感性分析证实了强度.

结论:

对35-64岁的女性进行VIA查,并用双价HPV疫苗接种9-14岁女孩的疫苗是中国最适合的宫癌预防策略.
更先进的查方法和9价值HPV疫苗在增加预算的情况下可能是可行的.
这项研究为中国的宫癌预防和控制政策提供了关键证据.

关键词:

宫癌是发生在宫癌的原因之一.马尔科夫模型的模型查检查查检查查检查疫苗接种疫苗接种

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