Cost-effectiveness analysis of introducing universal human papillomavirus vaccination of girls aged 11 years into the National Immunization Program in Brazil

Novaes, Hillegonda Maria Dutilh; Soárez, Patrícia Coelho de; Silva, Gulnar Azevedo; Ayres, Andréia Rodrigues Gonçalves; Itria, Alexander; Rama, Cristina Helena; Sartori, Ana Marli Christovam; Clark, Andrew; Resch, Stephen

doi:10.1016/j.vaccine.2014.12.031

Cited by 19 publications

(14 citation statements)

References 17 publications

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“…Still, these decisions are influenced by safety and efficacy of the vaccine; social norms and values related to sexual activity; confidence in vaccination programs and caregivers 9,10 . In our universal health system, individual financial limitations are not a significant influence in the decision-making since the vaccine is supplied to the target population without cost 11 .…”

Section: Isabel Cristina Esposito Sorpreso 1 Patricia Jane Kelly 2 mentioning

confidence: 99%

HPV vaccine: knowledge and acceptance to ensure effectiveness

Sorpreso

Kelly

2018

J. Hum. Growth Dev.

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The new Vaccine technologies against transmissible and non-transmissible diseases, such as cancer, have had an impact on international public health. The human papillomavirus (HPV) vaccine is used on a large scale in immunization programs in more than 58 countries, with resultant efficacy and safety for precursor lesions of cervical cancer, in addition to anogenital lesions. After the introduction of quadrivalent HPV vaccine (6,11,16 and 18) in Brazil in 2014, monitoring the vaccination coverage and the development of HPV prevalence incidence of cervical abnormalities and precancerous lesions must be observed, as well as morbidity and mortality trends from in situ and invasive cancer. Encouraging information, counseling and continuing education is recommended as a strategy to broaden vaccine acceptance in order to sediment its implementation and ensure effectiveness in reducing new cases of cervical cancer in the future.

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Section: Isabel Cristina Esposito Sorpreso 1 Patricia Jane Kelly 2 mentioning

confidence: 99%

HPV vaccine: knowledge and acceptance to ensure effectiveness

Sorpreso

Kelly

2018

J. Hum. Growth Dev.

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“…38 Most studies included in this review (13/20, 65%) evaluated vaccines introduced in the Brazilian NIP within the last 10 y (pneumococcal conjugate, HPV, rotavirus, meningococcal C conjugate, and hepatitis A) reflecting the local scenario at the time. Pneumococcal conjugate and HPV vaccines, which are used in multi-dose schedules, had high costs soon after marketing, and triggered more debates in the media and intense social pressure for incorporation, 29,39 were subject of more studies (4 and 3 Brazilian studies, respectively). In the review of Spanish HEEs on vaccines, pneumococcal vaccine was also the most frequently evaluated (10 studies, 21.7%), followed by influenza and hepatitis B vaccines (8 studies, 17.4%, each).…”

Section: Discussionmentioning

confidence: 99%

“…HTA/HEE to support vaccine introduction were conducted for all them. 17,19,25,28,29,39,[66][67] It is not easy to demonstrate how decision makers used economic evaluations when incorporating a new technology. We searched the NIP Technical Reports of new vaccines introduction, from 2006 to 2014, for citation of the economic evaluations -4 (PCV10, MenC, HPV and hepatitis A vaccines reports) of the 8 technical reports made reference to the cost-effectiveness analyses.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of health economic evaluations of vaccines in Brazil

Sartori

Rozman

Decimoni

et al. 2017

Human Vaccines & Immunotherapeutics

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Methods: Systematic review of the literature. We searched multiple databases. Two researchers independently selected the studies and extracted the data. The methodological quality of individual studies was evaluated using CHEERS items. Results: Twenty studies were reviewed. The most evaluated vaccines were pneumococcal (25%) and HPV (15%). The most used types of HEE were cost-effectiveness analysis (45%) and cost-utility analysis (20%). The research question and compared strategies were stated in all 20 studies and the target population was clear in 95%. Nevertheless, many studies did not inform the perspective of analysis or data sources. Conclusions: HEE of vaccines in Brazil has increased since 2008. However, the studies still have methodological deficiencies.

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“…As no NV vaccines are currently on the market, we used current cost estimates of another VLP-based vaccination, the human papilloma virus (HPV), from PAHO’s Revolving Fund and from a separate study in Brazil [26, 27]. This resulted in a cost of $13.19 per dose and a 2-dose cost of $26.44 when accounting for syringe costs.…”

Section: Methods and Datamentioning

confidence: 99%

Cost-effectiveness of norovirus vaccination in children in Peru

Mirelman

Ballard

Saito

et al. 2015

Vaccine

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Background With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. Methods We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru’s routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Results Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. Conclusions The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence rates are expected to be higher.

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Cost-effectiveness analysis of introducing universal human papillomavirus vaccination of girls aged 11 years into the National Immunization Program in Brazil

Cited by 19 publications

References 17 publications

HPV vaccine: knowledge and acceptance to ensure effectiveness

HPV vaccine: knowledge and acceptance to ensure effectiveness

A systematic review of health economic evaluations of vaccines in Brazil

Cost-effectiveness of norovirus vaccination in children in Peru

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