Cost-Effectiveness Analysis of the Bivalent and Quadrivalent Human Papillomavirus Vaccines from a Societal Perspective in Colombia

摘要: Objective To compare costs and effectiveness of three strategies used against cervical cancer (CC) genital warts: (i) Screening for CC; (ii) Bivalent Human Papillomavirus (HPV) 16/18 vaccine added to screening; (iii) Quadrivalent HPV 6/11/16/18 screening. Methods A Markov model was designed in order simulate the natural history disease from 12 years age (vaccination) until death. Transition probabilities were selected or adjusted match infection profile Colombia. A systematic review undertaken derive efficacy values two vaccines as well operational characteristics cytology test. The societal perspective used. Effectiveness measured number averted Disability Adjusted Life Years (DALYS). Results At commercial prices reported 2010 shown be non-cost-effective alternatives when compared with existing screening strategy. Sensitivity analyses showed that results are affected by cost their values, making it difficult determine certainty which has best cost-effectiveness profile. To ‘cost-effective’ should between 141 147 USD (Unite States Dollars) per vaccinated girl at most. But lower such those recommended WHO price other Colombia, vaccination could considered very cost-effective. Conclusions HPV a convenient alternative prevention CC However, this strategy cost-effective. It is also important take into consideration willingness pay, budgetary impact, program implications, relevance country, use program.