Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia

Johanna Aponte-González; Luisa Fajardo-Bernal; Jorge Diaz; Javier Eslava-Schmalbach; Oscar Gamboa; Joel W. Hay

doi:10.1371/journal.pone.0080639

Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia

Título traducido de la contribución: Análisis de costo-efectividad de las vacunas bivalentes y tetravalentes contra el virus del papiloma humano desde una perspectiva social en Colombia

Johanna Aponte-González, Luisa Fajardo-Bernal, Jorge Diaz, Javier Eslava-Schmalbach, Oscar Gamboa, Joel W. Hay

Producción: Contribución a una revista › Artículo › revisión exhaustiva

17 Citas (Scopus)

Resumen

Objetivo: Comparar los costos y la efectividad de tres estrategias utilizadas contra el cáncer de cuello uterino (CCU) y las verrugas genitales: (i) Tamizaje para CCU; (ii) Vacuna bivalente contra el virus del papiloma humano (VPH) 16/18 agregada al tamizaje; (iii) Vacuna cuadrivalente contra el VPH 6/11/16/18 agregada al tamizaje. Métodos: Se diseñó un modelo de Markov para simular la historia natural de la enfermedad desde los 12 años de edad (vacunación) hasta la muerte. Las probabilidades de transición se seleccionaron o ajustaron para que coincidieran con el perfil de infección por VPH en Colombia. Se realizó una revisión sistemática para derivar valores de eficacia para las dos vacunas, así como para las características operativas de la prueba citológica. Se utilizó la perspectiva social. La efectividad se midió en número de años de vida ajustados por discapacidad (AVAD) evitados. Resultados: A los precios comerciales reportados para 2010, las dos vacunas demostraron ser alternativas no costo-efectivas cuando se compararon con la estrategia de tamizaje existente. Los análisis de sensibilidad mostraron que los resultados se ven afectados por el costo de las vacunas y sus valores de eficacia, lo que dificulta determinar con certeza cuál de las dos vacunas tiene el mejor perfil de costo-efectividad. Para ser costo-efectivas, las vacunas deberían costar entre 141 y 147 USD (dólares estadounidenses) por niña vacunada, como máximo. Sin embargo, a precios más bajos, como los recomendados por la OMS o el precio de otras vacunas en Colombia, la vacunación contra el VPH podría considerarse muy costo-efectiva. Conclusiones: La vacunación contra el VPH podría ser una alternativa conveniente para la prevención del CaCu en Colombia. Sin embargo, el precio de la vacuna debería ser menor para que esta estrategia de vacunación sea costo-efectiva. También es importante tener en cuenta la disposición a pagar, el impacto presupuestario y las implicaciones del programa, para determinar la pertinencia de un programa de vacunación en este país, así como qué vacuna debería seleccionarse para su uso.

Título traducido de la contribución	Análisis de costo-efectividad de las vacunas bivalentes y tetravalentes contra el virus del papiloma humano desde una perspectiva social en Colombia
Idioma original	Inglés
Número de artículo	e80639
Páginas (desde-hasta)	1-14
Número de páginas	14
Publicación	PLoS ONE
Volumen	8
N.º	11
DOI	https://doi.org/10.1371/journal.pone.0080639
Estado	Publicada - 18 nov. 2013
Publicado de forma externa	Sí

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

Acceder al documento

10.1371/journal.pone.0080639

Otros archivos y enlaces

Enlace a la publicación en Scopus

Citar esto

@article{e9464d48104740c4bedf735b6e81ef9e,

title = "Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia",

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

author = "Johanna Aponte-Gonz{\'a}lez and Luisa Fajardo-Bernal and Jorge Diaz and Javier Eslava-Schmalbach and Oscar Gamboa and Hay, \{Joel W.\}",

year = "2013",

month = nov,

day = "18",

doi = "10.1371/journal.pone.0080639",

language = "English",

volume = "8",

pages = "1--14",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "11",

}

TY - JOUR

T1 - Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia

AU - Aponte-González, Johanna

AU - Fajardo-Bernal, Luisa

AU - Diaz, Jorge

AU - Eslava-Schmalbach, Javier

AU - Gamboa, Oscar

AU - Hay, Joel W.

PY - 2013/11/18

Y1 - 2013/11/18

N2 - Objective: To compare costs and effectiveness of three strategies used against cervical cancer (CC) and genital warts: (i) Screening for CC; (ii) Bivalent Human Papillomavirus (HPV) 16/18 vaccine added to screening; (iii) Quadrivalent HPV 6/11/16/18 vaccine added to screening. Methods: A Markov model was designed in order to simulate the natural history of the disease from 12 years of age (vaccination) until death. Transition probabilities were selected or adjusted to match the HPV infection profile in Colombia. A systematic review was undertaken in order to derive efficacy values for the two vaccines as well as for the operational characteristics of the cytology test. The societal perspective was used. Effectiveness was measured in number of averted Disability Adjusted Life Years (DALYS). Results: At commercial prices reported for 2010 the two vaccines were shown to be non-cost-effective alternatives when compared with the existing screening strategy. Sensitivity analyses showed that results are affected by the cost of vaccines and their efficacy values, making it difficult to determine with certainty which of the two vaccines has the best cost-effectiveness profile. To be 'cost-effective' vaccines should cost between 141 and 147 USD (Unite States Dollars) per vaccinated girl at the most. But at lower prices such as those recommended by WHO or the price of other vaccines in Colombia, HPV vaccination could be considered very cost-effective. Conclusions: HPV vaccination could be a convenient alternative for the prevention of CC in Colombia. However, the price of the vaccine should be lower for this vaccination strategy to be cost-effective. It is also important to take into consideration the willingness to pay, budgetary impact, and program implications, in order to determine the relevance of a vaccination program in this country, as well as which vaccine should be selected for use in the program.

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

UR - https://www.scopus.com/pages/publications/84894194749

U2 - 10.1371/journal.pone.0080639

DO - 10.1371/journal.pone.0080639

M3 - Article

C2 - 24260441

AN - SCOPUS:84894194749

SN - 1932-6203

VL - 8

SP - 1

EP - 14

JO - PLoS ONE

JF - PLoS ONE

IS - 11

M1 - e80639

ER -

Cost-effectiveness analysis of the bivalent and quadrivalent human papillomavirus vaccines from a societal perspective in Colombia

Resumen

ODS de las Naciones Unidas

Acceder al documento

Otros archivos y enlaces

Huella

Citar esto