Cost-effectiveness analysis of human papillomavirus vaccination in adolescent girls in Taiwan

Chao Hsiun Tang, Wen Fang Cheng, Jhih Hua Jiang, San Lin You, Lee Wen Huang, Jui Yu Hsieh, Piyali Mukherjee, Georges Van Kriekinge, Christa Lee

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Three vaccines are available to Taiwanese young girls for cervical cancer (CC) prevention. Here we evaluate the cost-effectiveness of the two-dose (2D) AS04-adjuvanted HPV-16/18 vaccine (2D-AS04-HPV-16/18v)+screening compared with a screening programme alone, with 2D human papillomavirus 6/11/16/18 vaccine (2D-4vHPVv)+screening, and with 2D/three-dose (3D) human papillomavirus 6/11/16/18/31/33/45/52/58 vaccine (9vHPVv)+screening, for Taiwan universal mass vaccination. Methods: A static Markov cohort model simulated the natural history of human papillomavirus (HPV) infection and CC screening for a 12-year-old cohort of Taiwanese girls (N=120,000). The model ran in 1-year cycles over the cohort's lifetime. Vaccine efficacy irrespective of HPV type was considered in the analysis for each vaccine. Input data were obtained from published literature, local databases, government reports and websites, and expert opinion. The analysis incorporated direct medical costs only, with an annual discount rate of 3.0%. The threshold was determined as 1 Gross Domestic Product per capita (New Taiwan dollar [NT$] 727,818; year 2016). Results: The 2D-AS04-HPV-16/18v+screening yielded 0.0365 quality-adjusted life year (QALY) gained at an additional cost of NT$ 5,770 per person compared with the screening programme alone. This resulted in an incremental cost-effectiveness ratio well below the threshold. Compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening, discounted results demonstrated additional QALYs gained at lower cost for 2D-AS04-HPV-16/18v+screening, making it dominant over both 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening. Conclusions: Vaccinating Taiwanese girls with 2D-AS04-HPV-16/18v in addition to screening to prevent CC is cost-effective compared with using a screening programme alone and the dominant option compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening.

原文英語
頁(從 - 到)1377-1387
頁數11
期刊Asian Pacific Journal of Cancer Prevention
20
發行號5
DOIs
出版狀態已發佈 - 一月 1 2019

指紋

Taiwan
Human papillomavirus 16
Cost-Benefit Analysis
Vaccination
Vaccines
Uterine Cervical Neoplasms
Human papillomavirus 11
Human papillomavirus 6
Costs and Cost Analysis
Quality-Adjusted Life Years
Gross Domestic Product
Mass Vaccination
Human papillomavirus 18
Local Government
Papillomavirus Infections
Expert Testimony
Early Detection of Cancer
Databases

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

引用此文

Cost-effectiveness analysis of human papillomavirus vaccination in adolescent girls in Taiwan. / Tang, Chao Hsiun; Cheng, Wen Fang; Jiang, Jhih Hua; You, San Lin; Huang, Lee Wen; Hsieh, Jui Yu; Mukherjee, Piyali; Van Kriekinge, Georges; Lee, Christa.

於: Asian Pacific Journal of Cancer Prevention, 卷 20, 編號 5, 01.01.2019, p. 1377-1387.

研究成果: 雜誌貢獻文章

Tang, CH, Cheng, WF, Jiang, JH, You, SL, Huang, LW, Hsieh, JY, Mukherjee, P, Van Kriekinge, G & Lee, C 2019, 'Cost-effectiveness analysis of human papillomavirus vaccination in adolescent girls in Taiwan', Asian Pacific Journal of Cancer Prevention, 卷 20, 編號 5, 頁 1377-1387. https://doi.org/10.31557/APJCP.2019.20.5.1377
Tang, Chao Hsiun ; Cheng, Wen Fang ; Jiang, Jhih Hua ; You, San Lin ; Huang, Lee Wen ; Hsieh, Jui Yu ; Mukherjee, Piyali ; Van Kriekinge, Georges ; Lee, Christa. / Cost-effectiveness analysis of human papillomavirus vaccination in adolescent girls in Taiwan. 於: Asian Pacific Journal of Cancer Prevention. 2019 ; 卷 20, 編號 5. 頁 1377-1387.
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abstract = "Three vaccines are available to Taiwanese young girls for cervical cancer (CC) prevention. Here we evaluate the cost-effectiveness of the two-dose (2D) AS04-adjuvanted HPV-16/18 vaccine (2D-AS04-HPV-16/18v)+screening compared with a screening programme alone, with 2D human papillomavirus 6/11/16/18 vaccine (2D-4vHPVv)+screening, and with 2D/three-dose (3D) human papillomavirus 6/11/16/18/31/33/45/52/58 vaccine (9vHPVv)+screening, for Taiwan universal mass vaccination. Methods: A static Markov cohort model simulated the natural history of human papillomavirus (HPV) infection and CC screening for a 12-year-old cohort of Taiwanese girls (N=120,000). The model ran in 1-year cycles over the cohort's lifetime. Vaccine efficacy irrespective of HPV type was considered in the analysis for each vaccine. Input data were obtained from published literature, local databases, government reports and websites, and expert opinion. The analysis incorporated direct medical costs only, with an annual discount rate of 3.0{\%}. The threshold was determined as 1 Gross Domestic Product per capita (New Taiwan dollar [NT$] 727,818; year 2016). Results: The 2D-AS04-HPV-16/18v+screening yielded 0.0365 quality-adjusted life year (QALY) gained at an additional cost of NT$ 5,770 per person compared with the screening programme alone. This resulted in an incremental cost-effectiveness ratio well below the threshold. Compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening, discounted results demonstrated additional QALYs gained at lower cost for 2D-AS04-HPV-16/18v+screening, making it dominant over both 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening. Conclusions: Vaccinating Taiwanese girls with 2D-AS04-HPV-16/18v in addition to screening to prevent CC is cost-effective compared with using a screening programme alone and the dominant option compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening.",
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author = "Tang, {Chao Hsiun} and Cheng, {Wen Fang} and Jiang, {Jhih Hua} and You, {San Lin} and Huang, {Lee Wen} and Hsieh, {Jui Yu} and Piyali Mukherjee and {Van Kriekinge}, Georges and Christa Lee",
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T1 - Cost-effectiveness analysis of human papillomavirus vaccination in adolescent girls in Taiwan

AU - Tang, Chao Hsiun

AU - Cheng, Wen Fang

AU - Jiang, Jhih Hua

AU - You, San Lin

AU - Huang, Lee Wen

AU - Hsieh, Jui Yu

AU - Mukherjee, Piyali

AU - Van Kriekinge, Georges

AU - Lee, Christa

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Three vaccines are available to Taiwanese young girls for cervical cancer (CC) prevention. Here we evaluate the cost-effectiveness of the two-dose (2D) AS04-adjuvanted HPV-16/18 vaccine (2D-AS04-HPV-16/18v)+screening compared with a screening programme alone, with 2D human papillomavirus 6/11/16/18 vaccine (2D-4vHPVv)+screening, and with 2D/three-dose (3D) human papillomavirus 6/11/16/18/31/33/45/52/58 vaccine (9vHPVv)+screening, for Taiwan universal mass vaccination. Methods: A static Markov cohort model simulated the natural history of human papillomavirus (HPV) infection and CC screening for a 12-year-old cohort of Taiwanese girls (N=120,000). The model ran in 1-year cycles over the cohort's lifetime. Vaccine efficacy irrespective of HPV type was considered in the analysis for each vaccine. Input data were obtained from published literature, local databases, government reports and websites, and expert opinion. The analysis incorporated direct medical costs only, with an annual discount rate of 3.0%. The threshold was determined as 1 Gross Domestic Product per capita (New Taiwan dollar [NT$] 727,818; year 2016). Results: The 2D-AS04-HPV-16/18v+screening yielded 0.0365 quality-adjusted life year (QALY) gained at an additional cost of NT$ 5,770 per person compared with the screening programme alone. This resulted in an incremental cost-effectiveness ratio well below the threshold. Compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening, discounted results demonstrated additional QALYs gained at lower cost for 2D-AS04-HPV-16/18v+screening, making it dominant over both 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening. Conclusions: Vaccinating Taiwanese girls with 2D-AS04-HPV-16/18v in addition to screening to prevent CC is cost-effective compared with using a screening programme alone and the dominant option compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening.

AB - Three vaccines are available to Taiwanese young girls for cervical cancer (CC) prevention. Here we evaluate the cost-effectiveness of the two-dose (2D) AS04-adjuvanted HPV-16/18 vaccine (2D-AS04-HPV-16/18v)+screening compared with a screening programme alone, with 2D human papillomavirus 6/11/16/18 vaccine (2D-4vHPVv)+screening, and with 2D/three-dose (3D) human papillomavirus 6/11/16/18/31/33/45/52/58 vaccine (9vHPVv)+screening, for Taiwan universal mass vaccination. Methods: A static Markov cohort model simulated the natural history of human papillomavirus (HPV) infection and CC screening for a 12-year-old cohort of Taiwanese girls (N=120,000). The model ran in 1-year cycles over the cohort's lifetime. Vaccine efficacy irrespective of HPV type was considered in the analysis for each vaccine. Input data were obtained from published literature, local databases, government reports and websites, and expert opinion. The analysis incorporated direct medical costs only, with an annual discount rate of 3.0%. The threshold was determined as 1 Gross Domestic Product per capita (New Taiwan dollar [NT$] 727,818; year 2016). Results: The 2D-AS04-HPV-16/18v+screening yielded 0.0365 quality-adjusted life year (QALY) gained at an additional cost of NT$ 5,770 per person compared with the screening programme alone. This resulted in an incremental cost-effectiveness ratio well below the threshold. Compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening, discounted results demonstrated additional QALYs gained at lower cost for 2D-AS04-HPV-16/18v+screening, making it dominant over both 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening. Conclusions: Vaccinating Taiwanese girls with 2D-AS04-HPV-16/18v in addition to screening to prevent CC is cost-effective compared with using a screening programme alone and the dominant option compared with 2D-4vHPVv+screening and 2D/3D-9vHPVv+screening.

KW - Cervical cancer

KW - Cost

KW - Effectiveness

KW - HPV vaccination

KW - Taiwan

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