[Evaluation of the cost-effectiveness of two alternative human papillomavirus vaccines as prophylaxis against uterine cervical cancer].
To determine the cost-effectiveness of human papillomavirus (HPV) vaccination and cervical lesion screening versus screening alone for the prevention of uterine cervical cancer (UCC).
This cost-effectiveness evaluation from the perspective of the Ministry of Health employed a Markov model with a 70-year time horizon and three alternatives for UCC prevention (screening alone, screening + bivalent vaccine, and screening + quadrivalent vaccine) in a hypothetical cohort of 10-year-old girls.
Our model, which was particularly sensitive to variations in coverage and in the prevalence of persistent infection by oncologic genotypes not included in the vaccine, revealed that HPV vaccination and screening is more cost-effective than screening alone, assuming a payment availability from S/ 2 000 (US dollars (USD) 1 290.32) per subject. In the deterministic analysis, the bivalent vaccine was marginally more cost-effective than the quadrivalent vaccine (S/ 48 [USD 30.97] vs. S/ 166 [USD 107.10] per quality-adjusted life-year, respectively). However, in the probabilistic analysis, both interventions generated clouds of overlapping points and were thus cost-effective and interchangeable, although the quadrivalent vaccine tended to be more cost-effective.
Assuming a payment availability from S/ 2000 [USD 1,290.32], screening and vaccination were more cost-effective than screening alone. The difference in cost-effectiveness between the two vaccines lacked probabilistic robustness, and therefore the vaccines can be considered interchangeable from a cost-effectiveness perspective.
Unidad de Análisis y Generación de Evidencias en Salud Pública. Centro Nacional de Salud Pública. Instituto Nacional de Salud. Lima, Perú.|Organización Médica para el desarrollo de la Salud. Lima, Perú.
Rafael
R
Bolaños-Díaz
Unidad de Análisis y Generación de Evidencias en Salud Pública. Centro Nacional de Salud Pública. Instituto Nacional de Salud. Lima, Perú.|Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas. Lima, Perú.
Romina A
RA
Tejada
Unidad de Análisis y Generación de Evidencias en Salud Pública. Centro Nacional de Salud Pública. Instituto Nacional de Salud. Lima, Perú.
Jessica
J
Beltrán
Sociedad Peruana de Administración de Salud. Lima, Perú.
Seimer
S
Escobedo-Palza
D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008390:Markov Chains; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000191:economics*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology
D053918:Papillomavirus Vaccines