From Medscape Medical News
Roxanne Nelson
July 2, 2009 — Vaccination against the human papillomavirus (HPV) is not cost-effective in the Netherlands, even under favorable assumptions that include lifelong protection against 70% of all cervical cancers, administration to all women regardless of their risk for cervical cancer, and no adverse effects.
According to a report published online July 1 in the Journal of the National Cancer Institute, in order for the HPV vaccine to become cost-effective among Dutch women, the price would have to be considerably reduced, depending on the long-term effectiveness of the vaccine.
Cost Effectiveness Tied to Declining Incidence
As in many industrialized nations, cervical-cancer–associated mortality has dramatically declined in the Netherlands, due to efficient and widespread screening programs. In 2005 it was 1.6 per 100,000 woman-years [World Standardized Rate (WSR)] in the Netherlands, and this rate is lower than the WSR of 2.5 per 100,000 woman-years in the United States for the period 2001–2005 and 1.9 in the United Kingdom in 2005, according to the authors.
A number of analyses have concluded that HPV vaccination should be cost-effective, but this conclusion is primarily dependent on the incidence and mortality rates of cervical cancer. Low incidence and mortality rates might limit the cost-effectiveness of adding HPV vaccination to a screening program, the researchers comment.
The team, led by Inge M.C.M. de Kok, from the department of public health at Erasmus MC University Medical Center, in Rotterdam, the Netherlands, examined the effect of adding HPV vaccination to the current Dutch cervical-cancer screening program..
Using a microsimulation screening analysis (MISCAN) model, the researchers estimated costs and effects of adding HPV vaccination to the current screening protocol in the Netherlands and examined the impact of changes in the price of vaccination, number of booster vaccinations, vaccination attendance rate, vaccination efficacy, cervical-cancer incidence level, and quality-of-life assumptions on the cost-effectiveness of HPV vaccination.
Cost Efficacy Lower Under Less Favorable Assumptions
There were limitations to the analysis, the researchers note. For example, the impact of herd or community immunity was underestimated, and the impact of the vaccine on other types of HPV-related diseases was also not taken into account.
While long-term adverse effects are not yet known and only a small number of adverse events have been reported in women between the ages of 15 to 26 years, most countries intend to vaccinate 12-year-old girls. Both safety and efficacy have not been tested in the age group, the researchers note, and since cervical cancer is a relatively rare disease in the Netherlands, adverse events due to vaccination will also influence the risk/benefit ratio of vaccination. This highlights the importance of future studies that will evaluate adverse effects among vaccinated 12-year-old girls, primarily for safety and also for cost-effectiveness estimates.
“In conclusion, many uncertainties still exist about the effects of HPV vaccination on HPV-related diseases,” the authors write. “Our cost-effectiveness analysis shows that in the Netherlands, a country with low cervical-cancer incidence and mortality, HPV vaccination is not cost-effective.”
GlaxoSmithKline provided funding for the study, to the department of public Health of the Erasmus University Medical Center. The authors made no disclosures.
J Natl Cancer Inst. Published online July 1, 2009.
for full article go to:
http://www.medscape.com/viewarticle/705220?sssdmh=dm1.493985&src=nldne
1 comment:
I'm 15 years old. I was born with HIV my mother passed away because of the HIV infection And I regret why i never met Dr Itua he could have cured my mum for me because as a single mother it was very hard for my mother I came across Dr itua healing words online about how he cure different disease in different races diseases like HIV/Aids Herpes,Parkison,Asthma,Autism,Copd,Epilepsy,Shingles,Cold Sore,Infertility, Chronic Fatigues Syndrome, Lupus Cure,Fibromyalgia,Love Spell,Prostate Cancer,Lung Cancer,Glaucoma.,psoriasis,Cirrhosis of Liver, Cataracts,Macular degeneration, Chrons disease,Infectious mononucleosis.,Cardiovascular disease,Lung disease.Enlarged prostate,Osteoporosis.Alzheimer's disease,psoriasis,Bipolar Disorder,Dementia.,Tach Disease,Breast Cancer,Blood Cancer,Colo-Rectal Cancer,Love Spell,Chronic Diarrhea,Ataxia,Arthritis,Amyotrophic Lateral Scoliosis,Stroke,Fibromyalgia,Fluoroquinolone ToxicitySyndrome Fibrodysplasia Ossificans ProgresSclerosis,Weak Erection,Breast Enlargment,Penis Enlargment,Hpv,measles, tetanus, whooping cough, tuberculosis, polio and diphtheria)Diabetes Hepatitis even Cancer I was so excited but frighten at same time because I haven't come across such thing article online then I contacted Dr Itua on Mail drituaherbalcenter@gmail.com/ . I also chat with him on what's app +2348149277967 he tells me how it works then I tell him I want to proceed I paid him so swiftly Colorado post office I receive my herbal medicine within 4/5 working days he gave me guild lines to follow and here am I living healthy again can imagine how god use men to manifest his works am I writing in all articles online to spread the god work of Dr Itua Herbal Medicine,He's a Great Man.
Post a Comment