Costo-utilidad de la vacuna contra el virus de papiloma humano en mujeres peruanas

Gutiérrez-Aguado, Alfonso

doi:10.1590/s1726-46342011000300003

Cited by 6 publications

(7 citation statements)

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“…In addition to these strategies, it is important to develop nationwide programs of formative research to identify and overcome local barriers to developing and performing successfully vaccination programs ( 29 ). By contrast, Gutierrez-Aguado ( 30 ) demonstrated that in Peru, HPV vaccination can be cost-utility compared with not vaccinating, with an incremental cost-utility of 6775 USD/QALY ( 30 ). In 2015, the Ministry of Health planned to vaccinate 475,000 girls ( 31 ).…”

Section: Is Massive Hpv Vaccination Suitable For the Peruvian Populatmentioning

confidence: 99%

Control of cervical cancer in Peru: Current barriers and challenges for the future

Aguilar

Pinto

Araujo

et al. 2016

Molecular and Clinical Oncology

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Cervical cancer is the leading malignant neoplasm in Peruvian women. This malignancy is a public health problem and several efforts were previously performed to develop cancer control plans. Geographical, cultural, structural, infrastructural and procedural barriers can limit the implementation of such strategies. Several previous studies have characterized human papilloma virus (HPV) epidemiology, where prevalence of high-risk HPV in adult females is ~12% and the prevalence in cervical cancer is 90–95%. The predominant barriers for the control of cervical cancer are lack of specialists in remote villages, education/cultural issues, loss of patients in follow-up, lack of access to HPV testing and lack of compliance for HPV vaccination. A good strategy for the prevention and early detection of high-risk HPV, pre-malignant neoplasms and cervical cancer, identified by interventional studies, is the self-sampling test, which assists with overcoming the cultural and geographic barriers. The current cancer control plan, termed ‘Plan Esperanza’, is performed with massive training of health professionals and social sensitization campaigns leading to filling the gaps regarding education and, in addition, it provides cancer care coverage for poorer individuals. In our experience at Oncosalud-AUNA, with a cohort of ~750,000 affiliates using a pre-paid system with annual screenings for cervical cancer for women, offered free-of-charge, a lower incidence of this malignancy (5.8/100,000) is now observed compared with the national incidence (32.7/100,000). As in other countries, the HPV vaccination can be a cost-utility strategy to reduce the high burdens of cervical cancer in Peru, a rapid and cheap HPV molecular sub-typification is rapidly required.

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Section: Is Massive Hpv Vaccination Suitable For the Peruvian Populatmentioning

confidence: 99%

Control of cervical cancer in Peru: Current barriers and challenges for the future

Aguilar

Pinto

Araujo

et al. 2016

Molecular and Clinical Oncology

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“…CVG was reported as unknown, and thus analyses had to simulate an assumed CVG [21–24, 26–29, 31, 33, 34, 37–46, 48–52]. Twenty-one studies identified vaccine coverage as a challenge [20, 24–26, 28–31, 33, 35, 36, 40–43, 46, 48–52], especially as there was no past experience of HPV vaccination programmes in the countries of study. Nine studies identified screening coverage as a challenge [25, 26, 30, 31, 33, 34, 42, 43, 46, 49].…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one studies identified vaccine coverage as a challenge [20, 24–26, 28–31, 33, 35, 36, 40–43, 46, 48–52], especially as there was no past experience of HPV vaccination programmes in the countries of study. Nine studies identified screening coverage as a challenge [25, 26, 30, 31, 33, 34, 42, 43, 46, 49]. Of these nine studies, two applied the coverage of current cervical cancer screening practice in a base case analysis and assessed the impact of enhanced screening coverage on the policy recommendation in the sensitivity analysis [31, 46].…”

Section: Resultsmentioning

confidence: 99%

“…Range of vaccine coverage was assumed10Goldie et al 2008 [28]CVG, vaccine coverageCVG: I$5–430Vaccine coverage: 0–90 %Range of CVG was to determine threshold price at which vaccine will be cost-effective since CVG was unknown. Range of vaccine coverage was assumed11Goldie et al 2008 [29]CVGCVG: I$5–360Range of CVG was to determine threshold price at which vaccine will be cost-effective since CVG was unknown12Goldie et al 2008 [32]CVGCVG: I$5–50Range of CVG was to determine threshold price at which vaccine will be cost-effective since CVG was unknown13Goldie et al 2012 [31]None––14Gutierrez-Aguado, 2011 [33]None––15Gutierrez-Delgado et al 2008 [34]CVGCVG: US$15.9–80 per doseRange of vaccine cost was to determine threshold price at which vaccine will be cost-effective16Insinga et al 2007 [35]Vaccine coverageVaccine coverage: 20–85 %Range of vaccine coverage was assumed17Jit et al 2014 [36]Not applicable––18Kawai et al 2012 [37]None––19Khatibi et al 2014 [38]None––20Kiatpongsan and Kim, 2014 [39]Not applicable––21Kim et al 2007 [40]CVG…”

Section: Resultsmentioning

confidence: 99%

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Challenges in Cost-Effectiveness Analysis Modelling of HPV Vaccines in Low- and Middle-Income Countries: A Systematic Review and Practice Recommendations

et al. 2016

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BackgroundLow- and middle-income countries (LMICs) face a number of challenges in implementing cervical cancer prevention programmes that do not apply in high-income countries.ObjectiveThis review assessed how context-specific challenges of implementing cervical cancer prevention strategies in LMICs were accounted for in existing cost-effectiveness analysis (CEA) models of human papillomavirus (HPV) vaccination.MethodsThe databases of MEDLINE, EMBASE, NHS Economic Evaluation Database, EconLit, Web of Science, and the Center for the Evaluation of Value and Risk in Health (CEA) Registry were searched for studies published from 2006 to 2015. A descriptive, narrative, and interpretative synthesis of data was undertaken.ResultsOf the 33 studies included in the review, the majority acknowledged cost per vaccinated girl (CVG) (26 studies) and vaccine coverage rate (21 studies) as particular challenges for LMICs, while nine studies identified screening coverage rate as a challenge. Most of the studies estimated CVG as a composite of different cost items. However, the basis for the items within this composite cost was unclear. The majority used an assumption rather than an observed rate to represent screening and vaccination coverage rates. CVG, vaccine coverage and screening coverage were shown by some studies through sensitivity analyses to reverse the conclusions regarding cost-effectiveness, thereby significantly affecting policy recommendations.ConclusionsWhile many studies recognized aspects of the particular challenges of HPV vaccination in LMICs, greater efforts need to be made in adapting models to account for these challenges. These include adapting costings of HPV vaccine delivery from other countries, learning from the outcomes of cervical cancer screening programmes in the same geographical region, and taking into account the country’s previous experience with other vaccination programmes.

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“…Tetravalent HPV vaccination was included in the National Vaccination Program approved in 2013 by the Ministry of Health, and three doses are given to girls from 5th and 6th grades of elementary school or girls 10 years old not in school, effectively protecting women before exposure to HPV (6)(7)(8). The plan includes free coverage for screening for cancer of the cervix in targeted populations (women ages 30 to 49), including cytology (PAP smear or liquid-based cytology), cervical visual inspection with acetic acid (VIA), and/or cryotherapy (see and treat), colposcopy, and molecular HPV tests (hybrid capture and/or PCR; refs.…”

mentioning

confidence: 99%

Cervical Cancer Prevention and Cancer Control in Latin America—Letter

Vidaurre

2015

Clinical Cancer Research

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Costo-utilidad de la vacuna contra el virus de papiloma humano en mujeres peruanas

Abstract: Materiales y métodos. Se realizó un análisis de-Resultados. Conclusiones. vacunar.

Cited by 6 publications

References 20 publications

Control of cervical cancer in Peru: Current barriers and challenges for the future

Control of cervical cancer in Peru: Current barriers and challenges for the future

Challenges in Cost-Effectiveness Analysis Modelling of HPV Vaccines in Low- and Middle-Income Countries: A Systematic Review and Practice Recommendations

Cervical Cancer Prevention and Cancer Control in Latin America—Letter

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