[Economic effectiveness of vaccination against papilloma virus in the Russian Federation].
OBJECTIVE
Perform pharmacoeconomic analysis of effectiveness of implementation of program of pre-exposition vaccination against HPV-associated diseases in the Russian Federation.


METHODS
Pharmacoeconomic analysis consisted of comparison of vaccination costs and assumed benefits of prevented losses from HPV-associated diseases from the society perspective as a whole under the condition of cohort vaccination of girls aged 12 years. A population model executed in MS Excel that allows to perform calculations and obtain results when initial data are changed was adapted for the analysis. The number of prevented HPV-associated diseases was determined by multiplying the number of disease cases observed per year and the effectiveness of the vaccine against each type of the disease. The resulting number of prevented cases was then multiplied by the cost of every HPV-associated condition, and as a result the benefit of vaccine use against human papilloma virus was determined.


RESULTS
The cervical cancer (CC) morbidity parameter in the Russian Federation is 13 807. By method of simple proportional extrapolation based on the European data, a calculation of morbidity in the Russian Federation was performed: atypical squamous cells of undetermined significance (ASCUS)--1 454 015; low grade cervical intraepithelial neoplasia (CIN 1)--660 207; high grade CIN2, CIN3--142 153. Vaccine effectiveness against CIN1, CIN2, CIN3 and CC would presumably be 45.9%, 65.1%, 85.7%, respectively. Vaccine effectiveness against these diseases caused by HPV type 16 and 18 would be 98%, and HPV type 31, 33, 45, 52, 58, 35, 39, 51, 56, 59 cumulatively--47.7%. The cost of HPV-associated diseases (per case) was 8200 RUR (Russian ruble) for ASCUS, 25 200 RUR for CIN1, 60 020 RUR for CIN2 and CIN3, average weighted cost of CC--188 772 RUR. The number of prevented cases of ASCUS, CIN1, CIN2, CIN3 and CC when vaccine was used was 322 791, 303 050, 92 496 and 11 827, respectively. The cost of vaccination of 1 cohort was 3.4 milliards RUR, and the prevented losses in Russian Federation were 19.4 milliards RUR.


CONCLUSIONS
The results of pharmacoeconomic analysis allow to assume that the cost of implementation of a program of vaccination against CC and other HPV-associated diseases in the Russian Federation are 5.4 times less compared with yearly preventable losses, that has a significant social and economical effect.
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MP
Kostinov
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Zverev
D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D032541:Mass Vaccination / Q000191:economics* / Q000379:methods / Q000458:organization & administration; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000191:economics; D012426:Russia; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*
D053918:Papillomavirus Vaccines