Journal of Medical Economics最新文献

Background: Infections are responsible for approximately 13% of cancer cases worldwide and many of these infections can be prevented by vaccination. Human papillomavirus (HPV) and hepatitis B virus (HBV) are among the most common infections that cause cancer deaths globally, despite effective prophylactic vaccines being available. This analysis aims to estimate the global burden and economic impact of vaccine-preventable cancer mortality across World Health Organization (WHO) regions.

Methods: The number of deaths and years of life lost (YLL) due to five different vaccine-preventable cancer forms (oral cavity, liver, laryngeal, cervical, and oropharyngeal cancer) in each of the WHO regions (African, Eastern Mediterranean, European, the Americas, South-East Asia Pacific, and Western Pacific) were obtained from the Institute for Health Metrics Evaluation global burden of disease dataset. Vaccine-preventable mortality was estimated considering the fraction attributable to infection, to estimate the number of deaths and YLL potentially preventable through vaccination. Data from the World Bank on GDP per capita were used to estimate the value of YLL (VYLL). The robustness of these results was explored with sensitivity analysis. Given that several Epstein-Barr virus (EBV) vaccines are in development, but not yet available, the impact of a potential vaccine for EBV was evaluated in a scenario analysis.

Results: In 2019, there were 465,740 potentially vaccine-preventable cancer deaths and 14,171,397 YLL across all WHO regions. The estimated economic impact due to this mortality was $106.3 billion globally. The sensitivity analysis calculated a range of 403,025-582,773 deaths and a range in productivity cost of $78.8-129.0 billion. In the scenario analysis EBV-related cancer mortality increased the global burden by 159,723 deaths and $32.4 billion.

Conclusion: Overall, the findings from this analysis illustrate the high economic impact of premature cancer mortality that could be potentially preventable by vaccination which may assist decision-makers in allocating limited resources among competing priorities. Improved implementation and increased vaccination coverage of HPV and HBV should be prioritized to decrease this burden.

Background: Cancer is the second leading cause of death in the Asia-Pacific region. Human papillomavirus (HPV) and hepatitis B virus (HBV) are major cancer-causing infections. This analysis assessed the mortality impact and productivity losses due to HBV- and HPV-related cancers in ten Asia-Pacific countries.

Methods: Number of deaths and years of life lost (YLL) in 2019 were sourced from the Institute for Health Metrics Evaluation Global Burden of Disease for the following: HBV-related liver cancer, and HPV-related oral cavity, larynx, oropharynx, and cervical cancers (other HPV-related cancers were not included). Ten countries from the Asia-Pacific region were included. Attributable fractions of HPV-related cancers were applied. Average YLL (AYLL) was calculated as the average number of years a person would have lived if they had not died prematurely. The value of YLL (VYLL) was estimated using GDP per capita and YLL. Discount rate of 3% was applied to adjust future health losses to present value. Sensitivity and scenario analyses were also conducted to assess the robustness of the results.

Results: In 2019, 52,796 deaths and 1,493,438 YLL were caused by HBV- and HPV-related cancer in the selected Asia-Pacific countries, incurring a productivity loss of $15 billion. Liver cancer accounted for 62.2% of the total productivity loss followed by cervical cancer (35.5%). The Asia-Pacific region had an AYLL of 28, with values ranging from 21 (Japan) to 34 (Philippines). Republic of Korea had the highest productivity losses followed by Japan and Thailand ($5.6, $4.3 and $1.8 billion, respectively).

Conclusion: The Asia-Pacific region bears a significant economic burden from potentially vaccine-preventable cancers. Enhanced public health measures, including screening and expanded HBV and HPV vaccination coverage, could alleviate this burden.