人乳头瘤病毒疫苗预防中国女性宫颈癌药物经济学研究的系统评价

Human Papillomavirus Vaccine Prevents Cervical Cancer in Chinese Women: A Systematic Review of Pharmacoeconomic Evaluation

关键词:  宫颈癌  HPV疫苗  药物经济学  系统评价

Key words:  cervical cancer  HPV vaccine  pharmacoeconomics  systematic review

摘要:

目的 系统评价人乳头瘤病毒（human papillomavirus，HPV）疫苗预防中国女性宫颈癌的药物经济学特性。方法 计算机检索PubMed、EMbase、中国知网（CNKI）、万方数据库（Wanfang Data）、维普数据库（CQVIP）、中国生物医学文献数据库（China Biology Medicine，CBM）等数据库，搜集关于HPV疫苗预防中国女性宫颈癌的药物经济学研究，检索时间从建库截至2020年2月。由2名研究者根据标准独立筛选文献、提取资料并使用卫生经济学评价报告标准共识（Consolidated Health Economic Evaluation Reporting Standards，CHEERS）和卫生经济研究质量评价（Quality of Health Economic Studies，QHES）对纳入文献进行质量评价，随后进行描述性分析。结果 共纳入15篇研究，其中4篇为成本效果研究，剩余11篇均为成本效用研究。9项研究来自中国大陆，5项来自中国台湾，1项来自中国香港，文献质量均较高。相比仅进行宫颈癌筛查和不干预，接种HPV疫苗合并进行宫颈癌筛查在无HPV感染史女性当中更具有经济性，但不同价型HPV疫苗之间的经济性结果不一致。结论 建议HPV疫苗纳入医保以及增加相关财政资金的投入，并且对不同价型HPV疫苗之间的经济性进行进一步的研究。

Abstract:

OBJECTIVE To systematically evaluate the pharmacoeconomic characteristics of human papillomavirus(HPV) vaccine on preventing cervical cancer in Chinese women. METHODS A global literature search from inception to February, 2020 was performed using database such as PubMed, EMbase, CNKI, Wanfang Data, CQVIP and China Biology Medicine(CBM) to collect pharmacoeconomic studies about HPV vaccine preventing cervical cancer in Chinese women. Two reviewers screened literature and collected data independently in compliance with the standards. The Consolidated Health Economic Evaluation Reporting Standards(CHEERS) and Quality of Health Economic Studies(QHES) were applied to evaluate the quality of the literature enrolled, then descriptive analysis was performed. RESULTS A total of 15 studies were included, 4 being cost-effectiveness studies, and the remaining 11 being cost-utility studies. Nine studies were from mainland China, 5 were from Taiwan China, and 1 was from Hong Kong China, the quality of literature was high. Compared with cervical cancer screening only and no intervention, HPV vaccination combines with cervical cancer screening was more cost-effective in women with no history of HPV infection. However, the economic results were inconsistent between different types of HPV vaccines. CONCLUSION It is recommended that the HPV vaccine should be included in the medical insurance and relevant financial investment should be increased. Further studies on the economic results between different types of HPV vaccine are also recommended.