HPV vaccination is highly effective and cost-effective for cervical cancer prevention in women living with HIV in China: A cost-effectiveness analysis

IF 5.7 2区 医学 Q1 ONCOLOGY
Hanting Liu, Maosheng Zou, Mingwang Shen, Adeeba Kamarulzaman, Simiao Chen, Jinghua Li, Rui Li, Huan Liu, Zhuoru Zou, Lei Zhang
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Abstract

The presence of human immunodeficiency virus (HIV) infection increases the risk of acquiring human papillomavirus (HPV) infection and developing HPV-related adversities. We aimed to estimate the cost-effectiveness of HPV vaccination for women living with HIV in a Chinese setting. A decision-analysis Markov model was developed to estimate the cost-effectiveness of 36 HPV vaccination strategies for women living with HIV aged 18–45 years, from the healthcare system perspective. With the status quo, not vaccinating women living with HIV would lead to 51.99% (51,985/100,000) HIV-related deaths; 35.10% (35,098/100,000) would develop genital warts, 0.36% (355/100,000) develop cervical cancer, and among which 63.66% (226/355) die from cervical cancer over their lifetime (1,601,457 person-years). With a willingness to pay (WTP) threshold of three times gross domestic product (GDP), Gardasil 4 vaccination for all women living with HIV aged 18–45 years was the most cost-effective strategy (ICER = US $32,766/QALY gained). This strategy would reduce genital warts by 35.52% (12,467/35,098), cervical cancers by 12.96% (46/355), and cervical cancer deaths by 12.39% (28/226) over the lifetime of the cohort. If the future domestic Cecolin 9 vaccine is priced at 60% of Gardasil 9, vaccinating all women living with HIV aged 18–45 years with Cecolin 9 would be the most cost-effective strategy (ICER = US $30,493/QALY gained). Improving adherence to antiretroviral therapy for HIV may substantially improve the cost-effectiveness of both Gardasil 4 and Cecolin 9 vaccination.

Abstract Image

接种 HPV 疫苗对中国女性艾滋病感染者预防宫颈癌非常有效且具有成本效益:成本效益分析。
人类免疫缺陷病毒(HIV)感染会增加感染人类乳头瘤病毒(HPV)和出现 HPV 相关不良反应的风险。我们的目的是估算在中国环境下为女性艾滋病感染者接种人乳头瘤病毒疫苗的成本效益。我们建立了一个决策分析马尔可夫模型,从医疗系统的角度估算了针对 18-45 岁女性艾滋病病毒感染者的 36 种 HPV 疫苗接种策略的成本效益。在维持现状的情况下,不为女性艾滋病病毒感染者接种疫苗将导致 51.99% (51,985/100,000)与艾滋病病毒相关的死亡;35.10% (35,098/100,000)会患生殖器疣,0.36% (355/100,000)会患宫颈癌,其中 63.66% (226/355)会在一生中死于宫颈癌(1,601,457 人-年)。如果支付意愿(WTP)阈值为国内生产总值(GDP)的三倍,那么为所有 18-45 岁感染艾滋病毒的女性接种加卫苗 4 是最具成本效益的策略(ICER = 32,766 美元/QALY gained)。这一策略将使生殖器疣减少 35.52%(12,467/35,098),宫颈癌减少 12.96%(46/355),宫颈癌死亡人数减少 12.39%(28/226)。如果未来国产 Cecolin 9 疫苗的定价为 Gardasil 9 的 60%,那么为所有 18-45 岁的女性艾滋病病毒感染者接种 Cecolin 9 疫苗将是最具成本效益的策略(ICER = 30,493 美元/QALY gained)。提高对艾滋病毒抗逆转录病毒疗法的依从性可大大提高加卫苗 4 和 Cecolin 9 疫苗接种的成本效益。
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来源期刊
CiteScore
13.40
自引率
3.10%
发文量
460
审稿时长
2 months
期刊介绍: The International Journal of Cancer (IJC) is the official journal of the Union for International Cancer Control—UICC; it appears twice a month. IJC invites submission of manuscripts under a broad scope of topics relevant to experimental and clinical cancer research and publishes original Research Articles and Short Reports under the following categories: -Cancer Epidemiology- Cancer Genetics and Epigenetics- Infectious Causes of Cancer- Innovative Tools and Methods- Molecular Cancer Biology- Tumor Immunology and Microenvironment- Tumor Markers and Signatures- Cancer Therapy and Prevention
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