Cost-effectiveness of the vaccine against human papillomavirus in the brazilian Amazon region

Revista da Associação Médica Brasileira

Allex Jardim Da Fonseca²  Luiz Carlos De Lima Ferreira²  Giacomo Balbinotto Neto¹ 

[1] ,Fundação de Medicina Tropical Doutor Heitor Vieira DouradoManaus AM ,Brazil

关键词: Cervical cancer;    Cost-effectiveness;    Human papillomavirus;    Vaccine;    Brazil;    Amazon region;    Câncer de colo de útero;    Custo-efetividade;    Papilomavírus humano;    Vacina;    Brasil;    Região amazônica;   

DOI  :  10.1016/j.ramb.2013.03.004

来源: SciELO

【 摘 要 】

OBJECTIVE: To assess the cost-utility of the human papillomavirus (HPV) vaccination on the prevention of cervical cancer in the Brazilian Amazon region. METHODS: AMarkov cohort modelwas developed to simulate the natural evolution of HPV and its progress to cervical cancer, considering the current preventive programs and treatment costs. The one-year transition probabilities were mainly based on empirical data of local and national studies. The model evaluated the addition of the vaccine to three cervical cancer-screening scenarios (0, 3 or 10 exams throughout life). RESULTS: The scenario of three Pap tests resulted in satisfactory calibration (base case). The addition of HPV vaccination would reduce by 35% the incidence of cervical cancer (70% vaccination coverage). The incremental cost-effectiveness ratio was US$ 825 for each quality-adjusted life year gained. The sensitivity analysis confirms the robustness of this result, and duration of immunity was the parameter with greater variation in incremental cost-effectiveness ratio. CONCLUSION: Vaccination has a favorable profile in terms of cost-utility, and its inclusion in the immunization schedule would result in a substantial reduction in incidence and mortality of invasive cervical cancer in the Brazilian Amazon region.

【 授权许可】

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