학술논문
Modeling the health and economic implications of adopting a 1-dose 9-valent human papillomavirus vaccination regimen in a high-income country setting: An analysis in the United Kingdom.
Document Type
Academic Journal
Author
Daniels V; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: vincent_daniels@merck.com.; Saxena K; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: kunal.saxena@merck.com.; Patterson-Lomba O; Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA 02199, USA. Electronic address: Oscar.Patterson-Lomba@analysisgroup.com.; Gomez-Lievano A; Analysis Group, Inc., 111 Huntington Ave, Floor 14, Boston, MA 02199, USA. Electronic address: Andres.Gomez-Lievano@analysisgroup.com.; Saah A; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: alfred_saah@merck.com.; Luxembourg A; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: alain_luxembourg@merck.coma.; Velicer C; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: christine_velicer@merck.com.; Chen YT; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: yating_chen@merck.com.; Elbasha E; Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA. Electronic address: elamin_elbasha@merck.com.
Source
Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 8406899 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2518 (Electronic) Linking ISSN: 0264410X NLM ISO Abbreviation: Vaccine Subsets: MEDLINE
Subject
Language
English
Abstract
Although no human papillomavirus (HPV) vaccine is indicated for single-dose administration, some observational evidence suggests that a 1-dose regimen might reduce HPV infection risk to that achieved with 2 doses. This study estimated the potential health and economic outcomes associated with switching from a 2-dose HPV vaccination program for girls and boys aged 13-14 years to an off-label 9-valent (9vHPV), 1-dose regimen, accounting for the uncertainty of the effectiveness and durability of a single dose. A dynamic HPV transmission infection and disease model was adapted to the United Kingdom and included a probabilistic sensitivity analysis using estimated distributions for duration of protection of 1-dose and degree of protection of 1 relative to 2 doses. One-way sensitivity analyses of key inputs were performed. Outcomes included additional cancer and disease cases and the difference in net monetary benefit (NMB). The 1-dose program was predicted to result in 81,738 additional HPV-related cancer cases in males and females over 100 years compared to the 2-dose program, ranging from 36,673 to 134,347 additional cases (2.5% and 97.5% quantiles, respectively), and had a 7.8% probability of being cost-effective at the £20,000/quality-adjusted life years willingness-to-pay (WTP) threshold. In one-way sensitivity analyses, the number of additional cancer cases was sensitive to the median of the duration of protection distribution and coverage rates. The differences in NMBs were sensitive to the median of the duration of protection distribution, dose price and discount rate, but not coverage variations. Across sensitivity analyses, the probability of 1 dose being cost-effective vs 2 doses was < 50% at the standard WTP threshold. Adoption of a 1-dose 9vHPV vaccination program resulted in more vaccine-preventable HPV-related cancer and disease cases in males and females, introduced substantial uncertainty in health and economic outcomes, and had a low probability of being cost-effective compared to the 2-dose program.
Competing Interests: Declaration of Competing Interest V Daniels, K Saxena, A Saah, A Luxembourg, C Velicer, Y Chen, and E Elbasha, are employees of Merck & Co., Inc., a manufacturer of HPV vaccines, and may own stocks and/or stock options. O Petterson-Lomba and A Gomez-Lievano are employees of Analysis Group, Inc. who were paid consultants to Merck & Co., Inc. in connection with the development of this manuscript.
(Copyright © 2022 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA and The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Competing Interests: Declaration of Competing Interest V Daniels, K Saxena, A Saah, A Luxembourg, C Velicer, Y Chen, and E Elbasha, are employees of Merck & Co., Inc., a manufacturer of HPV vaccines, and may own stocks and/or stock options. O Petterson-Lomba and A Gomez-Lievano are employees of Analysis Group, Inc. who were paid consultants to Merck & Co., Inc. in connection with the development of this manuscript.
(Copyright © 2022 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA and The Author(s). Published by Elsevier Ltd.. All rights reserved.)