1
|
The cost-effectiveness of bivalent, quadrivalent, and nine-valent HPV vaccination in Asia: a systematic review. Arch Gynecol Obstet 2022; 306:173-187. [PMID: 35380278 DOI: 10.1007/s00404-021-06309-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/21/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE The aim of this study was to systematically review the cost-effectiveness of HPV vaccination in Asia. METHODS We performed a systematic review of papers indexed in PubMed, Scopus, and Web of Science covering the period from 1 January 2000 to 13 August 2020. RESULTS Sixteen studies were included in the review. Half of them (8 studies) evaluated the cost-effectiveness of HPV vaccination in high-income countries and regions (HICs) while the other eight studies were set in low- and middle-income countries and regions (LMICs). In HICs, the implementation of bivalent, quadrivalent and nine-valent HPV vaccination was all shown to be cost-effective. Most studies (7/8) also showed that it was cost-effective to implement bivalent, quadrivalent, and nine-valent HPV vaccines in LMICs. However, one study concluded that it was not cost-effective to implement bivalent HPV vaccination in Thailand. CONCLUSION In general, the implementation of bivalent, quadrivalent and nine-valent HPV vaccination for adolescent girls was cost-effective in both high-income countries and regions and low- and middle-income countries and regions in Asia. Policy makers in HICs could consider expanding the target vaccinated population, while for LMICs it is essential to reduce HPV vaccine price to a level at which the implementation of HPV vaccination is cost-effective.
Collapse
|
2
|
Berhe HW, Al-arydah M. Computational modeling of human papillomavirus with impulsive vaccination. NONLINEAR DYNAMICS 2021; 103:925-946. [PMID: 33437129 PMCID: PMC7791917 DOI: 10.1007/s11071-020-06123-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/29/2020] [Indexed: 05/15/2023]
Abstract
In this study, a new SIVS epidemic model for human papillomavirus (HPV) is proposed. The global dynamics of the proposed model are analyzed under pulse vaccination for the susceptible unvaccinated females and males. The threshold value for the disease-free periodic solution is obtained using the comparison theory for ordinary differential equations. It is demonstrated that the disease-free periodic solution is globally stable if the reproduction number is less than unity under some defined parameters. Moreover, we found the critical value of the pulse vaccination for susceptible females needed to control the HPV. The uniform persistence of the disease for some parameter values is also analyzed. The numerical simulations conducted agreed with the theoretical findings. It is found out using numerical simulation that the pulse vaccination has a good impact on reducing the disease.
Collapse
|
3
|
Abidi S, Labani S, Singh A, Asthana S, Ajmera P. Economic evaluation of human papillomavirus vaccination in the Global South: a systematic review. Int J Public Health 2020; 65:1097-1111. [PMID: 32712694 DOI: 10.1007/s00038-020-01431-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Many reviews have been conducted on the economic evaluation of the HPV vaccine in global north countries. But there is a dearth of such reviews in the Global South countries. Hence, this systematic review aims to summarize studies done in these countries. METHODS Four databases PubMed, Embase, Cochrane Library, and Google Scholar from 2009 to 2019 were searched for economic evaluations on HPV vaccination in the Global South countries. PRISMA guidelines were followed to include full-text articles. 40 original articles were shortlisted for full-text review. RESULTS Studies had varied models, assumptions, and results according to different scenarios. Most studies concluded HPV vaccination to be cost-effective under varied scenarios and vaccine cost was the most influential parameter affecting the sensitivity analyses, consequently incremental cost-effectiveness ratio. A wide range in the cost-effectiveness ratio was observed in the included studies due to different study settings, populations, and inconsistencies in modeling practices (variations in methodological approaches). CONCLUSIONS This review suggests the introduction of HPV vaccination alone or in combination with screening according to different countries. The price of the vaccine should be economical and funds for the vaccine should be provided by public sector firms.
Collapse
Affiliation(s)
- Saba Abidi
- Delhi Pharmaceutical Sciences and Research University, New Delhi, India.
| | - Satyanarayana Labani
- Indian Council of Medical Research - National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Aastha Singh
- Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Smita Asthana
- Indian Council of Medical Research - National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Puneeta Ajmera
- Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| |
Collapse
|
4
|
Taychakhoonavudh S, Chumchujan W, Hutubessy R, Chaiyakunapruk N. Landscape of vaccine access and health technology assessment role in decision-making process in ASEAN countries. Hum Vaccin Immunother 2020; 16:1728-1737. [PMID: 32574124 PMCID: PMC7482843 DOI: 10.1080/21645515.2020.1769388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/09/2020] [Indexed: 12/29/2022] Open
Abstract
Over the past few years, many innovative vaccines became available that offer protection for diseases which have never been prevented before. While there are several factors that could have an impact on access, the use of health technology assessment (HTA) undoubtedly is also one of the contributing factors. Objectives: To explore the landscape of vaccine access and the role of HTA in new vaccine adoption in Association of Southeast Asian Nations (ASEAN) countries. Results: A great deal of progress has been made in terms of access to new and innovation vaccine in the region. Variation in access to these vaccines comparing between countries, however, is still observed. The use of HTA in supporting new vaccine adoption is still in an early stage especially in Gavi, the Vaccine Alliance-eligible countries. Conclusions: Improving the use of HTA evidences to support decision making could accelerate the efficient adoption of new vaccine in ASEAN region.
Collapse
Affiliation(s)
- Suthira Taychakhoonavudh
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Woralak Chumchujan
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Raymond Hutubessy
- Immunization, Vaccines and Biologicals (IVB) Department, World Health Organization, Geneva, Switzerland
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
5
|
Origoni M, Cristoforoni P, Mariani L, Costa S, Preti M, Sandri MT, Preti EP, Ghelardi A, Perino A. [HPV vaccination: not only female adolescents and not only prophylactic. Review and position paper of the Italian HPV Study Group (IHSG)]. ACTA ACUST UNITED AC 2019; 71:442-459. [PMID: 31741364 DOI: 10.23736/s0026-4784.19.04443-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
HPV vaccination has been introduced in clinical practice in recent years and represents the most effective strategy of primary prevention of cervical carcinoma and of female genital preneoplastic conditions. One of the major issues of the subject is represented by vaccination coverage of the target population. Since its introduction, HPV vaccine efficacy has been progressively demonstrated also towards extragenital HPV-correlated conditions and in males too. Moreover, even subjects of older age groups or subjects who already had HPV infections have been demonstrated to received benefits from vaccination, due to improvements of their immunological response. Recently, vaccine efficacy has also been investigated in terms of adjuvant administration after treatments of preneoplastic or benign conditions of the female lower genital tract caused by HPVs; preliminary results indicate an interesting and promising field of application. On this basis, in this article an analysis of the state of the art has been performed, with specific regard to the Italian scenario and with the focus of future perspectives of implementation of the HPV vaccination policy. From the available evidences, the Italian HPV Study Group recommends the extension of systematic HPV vaccination to males too, to adult subjects and also after conservative treatment of genital HPV correlated conditions.
Collapse
Affiliation(s)
- Massimo Origoni
- Dipartimento di Ginecologia e Ostetricia, Università Vita Salute San Raffaele, Milano, Italia -
| | | | | | | | - Mario Preti
- Dipartimento di Ginecologia e Ostetricia, Università di Torino, Torino, Italia
| | | | | | | | - Antonio Perino
- Dipartimento di Ginecologia e Ostetricia, Università di Palermo, Palermo, Italia
| | | |
Collapse
|
6
|
Messoudi W, Elmahi T, Nejjari C, Tachfouti N, Zidouh A, Saadani G, Moriña D, Diaz M. Cervical cancer prevention in Morocco: a model-based cost-effectiveness analysis. J Med Econ 2019; 22:1153-1159. [PMID: 31135231 DOI: 10.1080/13696998.2019.1624556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: Cervical cancer is a huge public health issue in Morocco which represents the second most frequent and fatal cancer among women. Countries that have not yet introduced the HPV vaccine could benefit greatly, but before implementation it is necessary to perform country-specific economic assessments that include current screening practices. Methods: A Markov model was developed to simulate the natural history of HPV and cervical cancer so as to calculate the long-term health benefits and costs of HPV vaccination and current screening by visual inspection with acetic acid (VIA). Starting from a previous transition probability matrix used for a model from Spain, the present model was calibrated to cervical cancer incidence from Morocco. Cost survey data was used to estimate the cost of screening and clinical procedures from the public healthcare perspective. Incremental cost-effectiveness ratios were calculated as 2018US$ per additional year of life saved (YLS) and both costs and health outcomes were discounted at 3%. Results: The expected reduction in lifetime risk of cervical cancer for current screening would be 14% at a cost of US$551/YLS compared with no intervention, assuming VIA every 3 years in women aged 30-49 at 10% coverage. HPV vaccination of pre-adolescent girls at 70% coverage would reduce the lifetime risk of cervical cancer by 62% at a cost of US$1,150/YLS, compared with no intervention. When implementing HPV vaccination in combination with current screening, vaccination would be dominated, and the combined strategy would provide a 69% reduction at a cost of US$2,843/YLS, compared with screening alone. Current screening would be dominated by vaccination when screening coverage is higher than 15%, whereas the combined strategy rapidly exceeds US$4,000/YLS. Conclusions: HPV vaccination could be highly effective and cost-effective in Morocco. Current screening would be good value for money compared with no intervention, but scaling-up screening coverage would make it inefficient compared with vaccination.
Collapse
Affiliation(s)
- Wadie Messoudi
- Laboratory of Coordination of Studies and Research in Analysis and Economic Forecast, Faculty of Law, Economics and Social Sciences, Université Sidi Mohamed Ben Abdellah , Fez , Morocco
| | - Toufik Elmahi
- Laboratory of Coordination of Studies and Research in Analysis and Economic Forecast, Faculty of Law, Economics and Social Sciences, Université Sidi Mohamed Ben Abdellah , Fez , Morocco
| | - Chakib Nejjari
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Université Sidi Mohamed Ben Abdellah , Fez , Morocco
| | - Nabil Tachfouti
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Université Sidi Mohamed Ben Abdellah , Fez , Morocco
| | - Ahmed Zidouh
- Lalla Salma Foundation for Cancer Prevention and Treatment , Rabat , Morocco
| | - Ghali Saadani
- Laboratory of Coordination of Studies and Research in Analysis and Economic Forecast, Faculty of Law, Economics and Social Sciences, Université Sidi Mohamed Ben Abdellah , Fez , Morocco
| | - David Moriña
- Barcelona Graduate School of Mathematics (BGSMath), Departament de Matemàtiques, Universitat Autònoma de Barcelona (UAB) , Cerdanyola del Vallès (Barcelona) , Spain
| | - Mireia Diaz
- Unit of Infections and Cancer (UNIC-I&I), Cancer Epidemiology Research Program, Institut Català d'Oncologia (ICO) - IDIBELL, L'Hospitalet de Llobregat , Barcelona , Spain
- Centro de Investigación Biomédica en Red (CIBERONC) , Madrid , Spain
| |
Collapse
|
7
|
Soe NN, Ong JJ, Ma X, Fairley CK, Latt PM, Jing J, Cheng F, Zhang L. Should human papillomavirus vaccination target women over age 26, heterosexual men and men who have sex with men? A targeted literature review of cost-effectiveness. Hum Vaccin Immunother 2018; 14:3010-3018. [PMID: 30024823 DOI: 10.1080/21645515.2018.1496878] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination for young women up to age 26 is highly cost-effective and has been implemented in 65 countries globally. We investigate the cost-effectiveness for HPV vaccination program in older women (age > 26 years), heterosexual men and men who have sex with men (MSM). METHOD A targeted literature review was conducted on PubMed for publications between January 2000 and January 2017 according to the PRISMA guidelines. We included English-language articles that reported the incremental cost-effectiveness ratio (ICER) of HPV vaccination programs for women over age 26, heterosexual men, and MSM and identified the underlying factors for its cost-effectiveness. RESULTS We included 36 relevant articles (six, 26 and four in older women, heterosexual men and MSM, respectively) from 17 countries (12 high-income (HICs) and five low- and middle-income (LMICs) countries). Most (4/6) studies in women over age 26 did not show cost-effectiveness ($65,000-192,000/QALY gained). Two showed cost-effectiveness, but only when the vaccine cost was largely subsidised and protection to non-naïve women was also considered. Sixteen of 26 studies in heterosexual men were cost-effective (ICER = $19,600-52,800/QALY gained in HICs; $49-5,860/QALY gained in LMICs). Nonavalent vaccines, a low vaccine price, fewer required doses, and a long vaccine protection period were key drivers for cost-effectiveness. In contrast, all four studies on MSM consistently reported cost-effectiveness (ICER = $15,000-$43,000/QALY gained), particularly in MSM age < 40 years and those who were HIV-positive. Countries' vaccination coverage did not significantly correlate with its per-capita Gross National Income. CONCLUSION Targeted HPV vaccination for MSM should be next priority in HPV prevention after having established a solid girls vaccination programme. Vaccination for heterosexual men should be considered when 2-dose 4vHPV/9vHPV vaccines become available with a reduced price, whereas targeted vaccination for women over age 26 is unlikely to be cost-effective.
Collapse
Affiliation(s)
- Nyi Nyi Soe
- a Research Centre for Public Health, School of Medicine , Tsinghua University , Beijing , China
| | - Jason J Ong
- b Melbourne Sexual Health Centre, Alfred Health , Melbourne , Australia.,c Central Clinical School, Faculty of Medicine , Monash University , Melbourne , Australia.,d London School of Hygiene and Tropical Medicine , London , UK
| | - Xiaomeng Ma
- a Research Centre for Public Health, School of Medicine , Tsinghua University , Beijing , China
| | - Christopher K Fairley
- b Melbourne Sexual Health Centre, Alfred Health , Melbourne , Australia.,c Central Clinical School, Faculty of Medicine , Monash University , Melbourne , Australia
| | - Phyu Mon Latt
- e Section of Epidemiology and Biostatistics, School of Population Health , The University of Auckland , Auckland , New Zealand
| | - Jun Jing
- a Research Centre for Public Health, School of Medicine , Tsinghua University , Beijing , China
| | - Feng Cheng
- a Research Centre for Public Health, School of Medicine , Tsinghua University , Beijing , China
| | - Lei Zhang
- a Research Centre for Public Health, School of Medicine , Tsinghua University , Beijing , China.,b Melbourne Sexual Health Centre, Alfred Health , Melbourne , Australia.,c Central Clinical School, Faculty of Medicine , Monash University , Melbourne , Australia.,f School of Public Health and Preventive Medicine, Faculty of Medicine , Monash University , Melbourne , Australia
| |
Collapse
|
8
|
Jit M, Brisson M. Potential lives saved in 73 countries by adopting multi-cohort vaccination of 9-14-year-old girls against human papillomavirus. Int J Cancer 2018; 143:317-323. [PMID: 29446090 PMCID: PMC6001440 DOI: 10.1002/ijc.31321] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/04/2018] [Accepted: 02/07/2018] [Indexed: 11/17/2022]
Abstract
Up to 2016, low- and middle-income countries mostly introduced routine human papillomavirus (HPV) vaccination for just a single age-cohort of girls each year. However, high-income countries have reported large reductions in HPV prevalence following "catch-up" vaccination of multiple age-cohorts in the year of HPV vaccine introduction. We used the mathematical model PRIME to project the incremental impact of vaccinating 10- to 14-year-old girls compared to routine HPV vaccination only in the same year that routine vaccination is expected to be introduced for 9-year-old girls across 73 low- and lower-middle-income countries. Adding multiple age-cohort vaccination could increase the number of cervical cancer deaths averted by vaccine introductions in 2015-2030 by 30-40% or an additional 1.23-1.79 million over the lifetime of the vaccinated cohorts. The number of girls needed to vaccinate to prevent one death is 101 in the most pessimistic scenario, which is only slightly greater than that for routine vaccination of 9-year-old girls (87). These results hold even when assuming that girls who have sexually debuted do not benefit from vaccination. Results suggest that multiple age-cohort vaccination of 9- to 14-year-old girls could accelerate HPV vaccine impact and be cost-effective.
Collapse
Affiliation(s)
- Mark Jit
- London School of Hygiene & Tropical MedicineLondonWC1E 7HTUnited Kingdom
- Public Health EnglandLondonWC1E 7HTUnited Kingdom
| | - Marc Brisson
- Centre de recherche du CHU de Québec, Université LavalLondonWC1E 7HTUnited Kingdom
| |
Collapse
|
9
|
Nguyen AD, Hoang MV, Nguyen CC. Medical costs for the treatment of cervical cancer at central hospitals in Vietnam. Health Care Women Int 2017; 39:442-449. [PMID: 29125392 DOI: 10.1080/07399332.2017.1402912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cervical cancer remains the second most common cancer amongst female aged 15 to 44 years old in Vietnam. We estimated medical costs for the treatment of cervical cancer patients. We employed the standard costing approach and health care provider perspective. We first computed the unit cost of 22 medical services related to cervical cancer treatments and then, based on standard cervical cancer treatment protocols, we estimated the cost of nine treatment scenarios for cervical cancer patients. We found that the medical costs for treatment of cervical cancers at central hospitals in Vietnam increased as the cancer progresses into later stages.
Collapse
Affiliation(s)
- Anh Duy Nguyen
- a Assisted Reproductive Department , Hanoi Obstetrics and Gynecology Hospital , Hanoi , Vietnam
| | - Minh Van Hoang
- b Center for Population Health Sciences, Hanoi University of Public Health , Hanoi , Vietnam
| | - Chuong Canh Nguyen
- c Screening and Diagnostic Prenatal Center, Hanoi Obstetrics and Gynecology Hospital , Hanoi , Vietnam
| |
Collapse
|