柳叶刀-全球健康|柳叶刀-全球健康｜国产HPV疫苗可为中国宫颈癌预防带来可观的经济回报( 二 )
Incremental QALYs and incremental costs of intervention strategies compared with the no intervention scenario. Names of the strategies located on the cost-effectiveness frontier and their incremental cost-effectiveness ratios compared with the lower-cost non-dominated strategy are shown. The strategies on the upper left of the frontier are dominated by the strategies on the lower right of them. Incremental QALYs and incremental costs are expressed as the value on Dec 31, 2019. VIA=visual inspection with acetic acid. Pap=Papanicolaou test. HC-2=Hybrid Capture-2. LBC=liquid-based cytology. QALY=quality-adjusted-life-year. GDP=gross domestic product.
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Figure 2:Cost-effectiveness acceptability curves for all strategies
Intervention strategies that never have the highest probability of being cost-effective within the willingness-to-pay threshold of three-times the Chinese per-capita GDP are represented in grey. VIA=visual inspection with acetic acid. QALYs=quality-adjusted life-years. GDP=gross domestic product.
若中国响应世界卫生组织在全球范围内消除宫颈癌的目标，启动常规的适龄女性HPV疫苗接种计划，疫苗价格很可能进一步下调 。该研究表明，当疫苗接种总成本降低至50美元时，即使以1倍中国人均GDP作为支付意愿阈值，疫苗接种结合筛查的方案也将比对应的单独筛查方案更具成本效果 。当疫苗接种总成本大幅降低至10美元时，只有在支付意愿非常低的情况下（约
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Figure 3:Cost-effectiveness acceptability curves for all strategies at various costs of vaccination
Intervention strategies that never have the highest probability of being cost-effective within the willingness-to-pay threshold of three-times the Chinese per-capita GDP are represented in grey. VIA=visual inspection with acetic acid. QALY=quality adjusted life-year. GDP=gross domestic product.
从卫生经济学角度考虑，中国现阶段应采取普遍的宫颈癌预防策略 。青少年女性HPV疫苗接种结合成年女性每隔5年进行一次careHPV筛查是当前成本效果最优的方案 。进一步降低国产HPV疫苗价格，将为中国宫颈癌免疫预防带来更高的经济回报 。该项研究成果可为当前中国宫颈癌防控策略制定提供重要参考依据，对推动中国适龄女性普遍HPV疫苗接种计划的实施具有重要意义 。END
参考文献
1.Bruni L Albero G Serrano B et al. ICO/IARC information centre on HPV and cancer (HPV information centre). Human papillomavirus and related diseases in the world. Summary report.
https://hpvcentre.net/statistics/reports/XWX.pdf?t=1596108932106 Date: 22 January 2019 Date accessed: June 5, 2019
2.WHO Comprehensive cervical cancer control: a guide to essential practice. 2nd edn. World Health Organization, Geneva2014
7.Qiao YL Wu T Li CR et al. Efficacy, safety, and immunogenicity of an Escherichia coli-produced bivalent human papillomavirus vaccine: an interim analysis of a randomised clinical trial. J Natl Cancer Inst. 2019; 112: 145-153
8.Zhu FC Chen W Hu YM et al. Efficacy, immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in healthy Chinese women aged 18–25 years: results from a randomized controlled trial. Int J Cancer. 2014; 135: 2612-2622
*中文翻译仅供参考，所有内容以英文原文为准 。
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