[Generalized cost-effectiveness of preventive interventions against cervical cancer in Mexican women: results of a Markov model from the public sector perspective].
OBJECTIVE
To develop a generalized cost-effectiveness analysis (GCEA) of the HPV vaccine, hybrid capture screening (HC) and Papanicolaou screening (Pap) in the Mexican context.


METHODS
From April to August 2007, in Mexico, a GCEA of the interventions was developed for 10 possible scenarios using a Markov model from the public sector perspective as payer.


RESULTS
Scenarios considering 80% coverage show an ACER per DALY averted of $16678 pesos for Pap of women between ages 25 and 64, $17277 pesos for HC of women between ages 30 and 64, and $84008 pesos for vaccination of 12-year-old girls. Annual financing of $621, $741 and $2255 million pesos, respectively, is needed for these scenarios.


CONCLUSIONS
A selective, combined introduction of Pap-HC screening that considers the comparative advantages of application in different populations and geographical areas is suggested. Additionally, it is suggested to introduce the vaccine once a threshold price of $181 pesos per dose -when the vaccine becomes equal in terms of cost-effectiveness to HC- has been achieved.
Gutiérrez-Delgado
Cristina
C
Unidad de Análisis Económico, Secretaría de Salud, México. cgutierrezd@salud.gob.mx
Báez-Mendoza
Camilo
C
González-Pier
Eduardo
E
de la Rosa
Alejandra Prieto
AP
Witlen
Renee
R
D000293:Adolescent; D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008390:Markov Chains; D008800:Mexico; D008875:Middle Aged; D053918:Papillomavirus Vaccines / Q000191:economics*; D017150:Public Sector; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000517:prevention & control*
D053918:Papillomavirus Vaccines