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Van Minh H, My NTT, Jit M. Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study. BMC Health Serv Res 2017; 17:353. [PMID: 28506297 PMCID: PMC5433243 DOI: 10.1186/s12913-017-2297-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 05/08/2017] [Indexed: 02/01/2023] Open
Abstract
Background Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. Methods The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. Results The cost of cervical cancer treatment ranged from US$368 – 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000. Conclusion HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.
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Affiliation(s)
- Hoang Van Minh
- Hanoi University of Public Health, Building A, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam.
| | - Nguyen Thi Tuyet My
- Hanoi University of Public Health, Building A, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Modelling and Economics Unit, Public Health England, London, UK
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Brandt HM, Sharpe PA, McCree DH, Wright MS, Davis J, Hutto BE. HPV Vaccine Acceptance in a Clinic-based Sample of Women in the Rural South. AMERICAN JOURNAL OF HEALTH EDUCATION 2009. [DOI: 10.1080/19325037.2009.10599092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Heather M. Brandt
- a Arnold School of Public Health , University of South Carolina , 800 Sumter St. HESC, Columbia , SC , 29208
| | - Patricia A. Sharpe
- b Arnold School of Public Health Prevention Research Center , University of South Carolina , Columbia , SC , 29208
| | - Donna H. McCree
- c National Center for HIV, STD and TB Prevention , Centers for Disease Control and Prevention , Atlanta , GA , 30333
| | - Marcie S. Wright
- d Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , 29208
| | - Jennifer Davis
- e Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , 29208
| | - Brent E. Hutto
- f Arnold School of Public Health Prevention Research Center , University of South Carolina , Columbia , SC , 29208
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Vetter KM, Geller SE. Moving forward: human papillomavirus vaccination and the prevention of cervical cancer. J Womens Health (Larchmt) 2008; 16:1258-68. [PMID: 18001182 DOI: 10.1089/jwh.2007.0493] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
In June 2006, the Food and Drug Administration (FDA) approved the first human papillomavirus (HPV) vaccine. The vaccine was subsequently recommended by the Centers for Disease Control and Prevention's (CDC) Advisory Committee for Immunization Practices (ACIP) for routine vaccination of 11-12-year-old girls and catch-up vaccination of females 13-26 years of age. With the approval of the first HPV vaccine, cervical cancer now has a primary prevention tool. However, the availability of an HPV vaccine will not change the course of cervical cancer in this country unless there is both widespread demand by and access for the targeted populations. Demand will require recognition of the need for protection against HPV infection as well as a positive perception of the vaccine as safe and efficacious. General knowledge of HPV and its relationship to cervical cancer is limited; some parents and healthcare providers are hesitant to vaccinate preadolescent girls. Access to the expensive vaccine will not be increased without addressing financial constraints. Although the Vaccines for Children (VFC) program has added HPV to its vaccine plan, not all private insurers have approved coverage, and the uninsured and underinsured may have limited access. Moving forward will require a well-planned and executed public information campaign by trusted sources and the development of a comprehensive vaccine administration program. Although mandates would assure the broadest coverage, controversies surrounding mandates may deter work toward broad coverage. States should focus on developing a comprehensive program and then return to the mandate issue if coverage does not meet public health objectives.
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Affiliation(s)
- Kathleen M Vetter
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA
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Dowling TS. Mandating a human papillomavirus vaccine: an investigation into whether such legislation is constitutional and prudent. AMERICAN JOURNAL OF LAW & MEDICINE 2008; 34:65-84. [PMID: 18512537 DOI: 10.1177/009885880803400103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Merck’s recently released vaccine, Gardasil, may revolutionize cervical cancer prevention. With the rate of detected cervical cancer cases and associated deaths rising rapidly, cervical cancer is a major public health concern. Infection with the human papillomavirus, a sexually transmitted disease, is a necessary cause of cervical cancer. Gardasil protects against two specific “high risk” strains of HPV, associated with about 70% of cervical cancer cases, and blocks infection by two other strains of HPV, responsible for 90% of genital warts cases. Proponents of Gardasil believe that vaccination of women between the ages of 12 and 26 can slow the spread of cervical cancer by eradicating the two major HPV strands associated with the cancer’s development.
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Esposito S, Bosis S, Pelucchi C, Begliatti E, Rognoni A, Bellasio M, Tel F, Consolo S, Principi N. Pediatrician knowledge and attitudes regarding human papillomavirus disease and its prevention. Vaccine 2007; 25:6437-46. [PMID: 17673339 DOI: 10.1016/j.vaccine.2007.06.053] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 05/23/2007] [Accepted: 06/22/2007] [Indexed: 10/23/2022]
Abstract
Between 1 September and 8 October 2006, we used a self-administered, anonymous questionnaire in order to evaluate knowledge and attitudes regarding HPV disease and its prevention in a nationally representative sample of Italian pediatricians. Three hundred and eleven of the 400 enrolled physicians (175 primary care pediatricians, 160 hospital pediatricians and 65 residents in pediatrics) returned completed surveys (227 females; mean age+/-standard deviation, 45.3+/-11.61 years). The results showed a lack of knowledge concerning HPV disease and its prevention, with marginal differences between the subgroups, even though the majority would recommend HPV vaccination. These findings highlight an urgent need to improve pediatrician information in order to ensure the optimal implementation of HPV vaccination, and the adequate acceptability of HPV vaccines to adolescents and their parents.
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Affiliation(s)
- Susanna Esposito
- Institute of Pediatrics, University of Milan, Fondazione IRCCS "Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena", Via Commenda 9, 20122 Milan, Italy
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Morris BJ, Rose BR. Cervical screening in the 21st century: the case for human papillomavirus testing of self-collected specimens. Clin Chem Lab Med 2007; 45:577-91. [PMID: 17484617 DOI: 10.1515/cclm.2007.127] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cervical screening by Pap smear involves a high rate of false negatives, necessitating frequent testing. Because women do not like the sampling procedure, many avoid being screened. Testing for the causative high-risk human papillomavirus (HPV) types, by PCR or other technologies, on self-collected (tampon) samples permits women to be monitored non-invasively. The high negative predictive value of HPV testing means a greater interval between tests, and thus reduces costs. HPV testing lends itself to primary screening. A kit for self-collection and return to a testing laboratory, followed by practitioner notification and follow-up if required, should result in wider participation. The higher accuracy of HPV testing should lead to improved cervical cancer prevention.
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Affiliation(s)
- Brian J Morris
- Basic and Clinical Genomics Laboratory, School of Medical Sciences and Bosch Institute, The University of Sydney, Sydney, NSW, Australia.
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Abstract
Patients and clinicians experience the frustration of cutaneous viral warts caused by infection with the human papilloma virus (HPV).Warts appear in various forms on different sites of the body and include common warts (verruca vulgaris), plane or flat warts, myrmecia, plantar warts, coalesced mosaic warts, filiform warts, periungual warts, anogenital warts (venereal or condyloma acuminata), oral warts and respiratory papillomas. Cervical infection with HPV is now known to cause cervical cancer if untreated. A review of the medical literature reveals a huge armamentarium of wart monotherapies and combination therapies. Official evidence-based guidelines exist for the treatment of warts, but very few of the reported treatments have been tested by rigorous blinded, randomized controlled trials.Therefore, official recommendations do not often include treatments with reportedly high success rates, but they should not be ignored when considering treatment options. It is the purpose of this review to provide a comprehensive overview of the wart treatment literature to expand awareness of the options available to practitioners faced with patients presenting with problematic warts.
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Affiliation(s)
- Michelle M Lipke
- MPAS, PA-C, Department of Dermatology, Marshfield Clinic-Wausau Center, Wausau, WI 54401, USA.
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Martinón-Torres F, Bernaola Iturbe E, Giménez Sánchez F, Baca Cots M, De Juan Martín F, Díez Domingo J, Garcés Sánchez M, Gómez Campderá JA, Picazo JJ, Pineda Solas V. Vacuna frente al virus del papiloma humano: un nuevo reto para el pediatra. An Pediatr (Barc) 2006; 65:461-9. [PMID: 17184607 DOI: 10.1157/13094258] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Human papillomavirus (HPV) infections are the most common sexually transmitted infections in the world. This infection is a necessary cause of cervical cancer, has been related to other forms of anogenital, airway and digestive cancers, and also causes anogenital warts. The recent advances in HPV prophylactic vaccines and their imminent commercial availability will post a new challenge to pediatricians: the indication and administration of these vaccines for the prevention of HPV infection, and consequently, of cervical cancer and other HPV-related diseases. The present article reviews the essentials of HPV infection, its relationship with cervical cancer, the advances in prophylactic HPV vaccines, and the role of the pediatrician in this context.
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Affiliation(s)
- F Martinón-Torres
- Comité Asesor de Vacunas, Asociación Española de Pediatría, auspiciado por Sanofi Pasteur MSD
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Current World Literature. Curr Opin Obstet Gynecol 2006. [DOI: 10.1097/01.gco.0000242963.55738.b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sherris J, Friedman A, Wittet S, Davies P, Steben M, Saraiya M. Chapter 25: Education, training, and communication for HPV vaccines. Vaccine 2006; 24 Suppl 3:S3/210-8. [PMID: 16950009 DOI: 10.1016/j.vaccine.2006.05.124] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Accepted: 05/31/2006] [Indexed: 11/16/2022]
Abstract
As human papillomavirus (HPV) vaccines come to market, they will face education and training challenges similar to those of other new vaccines, along with HPV-specific issues. Recent studies document stark knowledge gaps about HPV at all levels--among policy makers, healthcare providers, parents, and teens--in both the industrialized and developing worlds. Pharmaceutical companies, public health advocates, medical trainers, and health educators need to understand their diverse audiences and respond appropriately to the needs of each. They also must use research-based communication strategies and materials to most effectively, and accurately, convey the need for an HPV vaccine and to manage expectations about how the vaccine can, and cannot, protect women and men.
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Affiliation(s)
- Jacqueline Sherris
- Program for Appropriate Technology in Health, 1455 NW Leary Way, Seattle, WA 98107, USA.
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Abstract
Human papillomavirus type-16 infection is associated with a significant portion of squamous carcinoma of the head and neck, particularly for the oropharynx and for those lacking the other risk factors of tobacco and alcohol. The link between human papillomavirus type-16 and carcinoma of the oropharynx is based on the identification of human papillomavirus type-16 in oropharyngeal tumors and the association of human papillomavirus type-16 with the risk of oropharyngeal cancer estimated in case-control epidemiologic studies. This review highlights the molecular mechanism of human papillomavirus carcinogenesis and the association of human papillomavirus type-16 as a risk factor for squamous cell carcinoma of the oropharynx as well as recent research efforts utilizing human papillomavirus as a biomarker of clinical outcomes.
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Affiliation(s)
- Guojun Li
- Department of Head and Neck Surgery, Unit 441, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
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