利用PRIME工具快速评估武汉地区接种二价人乳头瘤病毒疫苗的卫生经济学

Rapid Evaluation of Health Economics of Bivalent HPV Vaccination in Wuhan Based on PRIME Tool

目的:结合武汉地区的实际情况进行本地化的人乳头瘤病毒(HPV)疫苗卫生经济学快速评估,为及时出台适合武汉地区的HPV疫苗接种策略提供科学依据。方法:利用HPV疫苗建模与经济学评估快速界面(PRIME)工具,对工具的关键参数进行改进及替换,评估武汉地区接种HPV疫苗的卫生经济学。结果:同一出生队列的武汉女性,在目标年龄完成全程二价HPV疫苗接种,其后一生中各年龄段患宫颈癌的概率明显降低。如对当前武汉地区12岁女性接种二价HPV疫苗,考虑3%的贴现后,每投入701262元即可避免1例宫颈癌病例,每投入1721915元即可避免1例宫颈癌死亡,每投入83496元即可挽救1个因宫颈癌导致的伤残调整生命年(DALY)。敏感性分析显示贴现率引起的增量成本效用比(ICUR)变化最大,贴现率(1%~5%)调整后,增量成本效用比变化在31752~196045元/DALY之间,均低于世界卫生组织(WHO)推荐用于判断干预措施经济性的ICUR阈值。结论:在武汉地区12岁女性中引入二价HPV疫苗具有较好的成本效果。

Objective:To evaluate the health economics of bivalent human papillomavirus(HPV)vaccination in Wuhan to provide scientific basis for the timely introduction of HPV vaccination strategies in Wuhan city.Methods:Papillomavirus rapid interface for modelling and economics(PRIME)tool was used to evaluate the health economics of HPV vaccination in Wuhan.The key parameters of tool were modified according to the conditions of Wuhan.Results:Women in the same birth cohort in Wuhan who completed the full course of bivalent HPV vaccination at the target age had a significantly lower risk of cervical cancer in their later life.If the 12-yearold female in Wuhan was vaccinated with bivalent HPV vaccine,into which the discount rate was introduced,every 701262 yuan invested could prevent one case of cervical cancer,every 1721975 yuan invested could prevent one case of death from cervical cancer,every 83496 yuan invested could save a disability adjusted life year(DALY)due to cervical cancer.Sensitivity analysis showed that the main factor leading to the change of incremental cost-utility ratio(ICUR)was the discount rate.After the adjustment of discount rate(1%-5%),the ICUR varied from 31752 yuan/DALY to 196045 yuan/DALY,which was below the threshold recommended by the World Health Organization(WHO)to determine the economics of interventions.Conclusion:Bivalent HPV vaccination in 12-yearold women in Wuhan has good cost-effectiveness.