HPV疫苗的高价格仍然是中国获得疫苗的重大障碍，阻碍了中国消除宫颈癌的努力，并加剧了健康不平等。我们的目的是通过确定阈值价格来为 HPV 疫苗价格谈判提供信息，以确保政府资助的 HPV 疫苗接种计划具有成本效益或节省成本。我们使用先前经过验证的传播模型来估计 HPV 疫苗接种对健康和经济的影响。从医疗保健支付者的角度来看 100 年的时间范围。考虑不同环境（国家、农村和城市）、宫颈癌筛查场景（基于细胞学或基于 HPV DNA，不同的扩大规模）、疫苗类型（中国有四种类型）、疫苗进行阈值分析。时间表（两剂或一剂）、疫苗接种方式（常规疫苗接种或后期转用高效疫苗）、支付意愿门槛和决策标准（成本效益或节省成本） 。此外，我们还研究了按确定的阈值价格在全国范围内进行疫苗接种对预算的影响。按照当前的市场价格，使用任何现有疫苗进行全国常规 HPV 疫苗接种不太可能具有成本效益。在两剂接种计划下，四种可用 HPV 疫苗类型的价格不能超过每剂 26-36 美元（比当前市场价格降低 44.1%-80.2%），具体取决于疫苗类型，以确保国家计划的成本效益。采用门槛价疫苗接种将需要中国每年增加国家免疫规划（NIP）预算总额的72.18%-96.95%。节省成本的常规疫苗接种计划要求每剂疫苗价格为 5-10 美元（取决于疫苗类型），从而使年度 NIP 预算增加 21.38%-34.23%。与一剂方案相比，添加第二剂不太可能具有成本效益，因为阈值价格接近甚至低于零。与国家计划相比，农村试点疫苗接种计划所需的门槛价格较低。我们的研究可以为疫苗价格谈判提供信息，从而促进中国目前 HPV 疫苗接种试点计划在全国范围内的推广。这些证据对于因高成本而面临 HPV 引入障碍的其他国家可能具有潜在价值。这种方法也可以适用于涉及引入昂贵疫苗的其他情况。CAMS 医学科学创新基金 (CIFMS)；账单

The high price of HPV vaccines remains a significant barrier to vaccine accessibility in China, hindering the country's efforts toward cervical cancer elimination and exacerbating health inequity. We aimed to inform HPV vaccine price negotiations by identifying threshold prices that ensure that a government-funded HPV vaccination programme is cost-effective or cost-saving.We used a previously validated transmission model to estimate the health and economic impact of HPV vaccination over a 100-year time horizon from a healthcare payer perspective. Threshold analysis was conducted considering different settings (national, rural, and urban), cervical cancer screening scenarios (cytology-based or HPV DNA-based, with different paces of scale-up), vaccine types (four types available in China), vaccine schedules (two-dose or one-dose), mode of vaccination (routine vaccination with or without later switching to high-valency vaccines), willingness-to-pay thresholds, and decision-making criteria (cost-effective or cost-saving). Furthermore, we examined the budget impact of introducing nationwide vaccination at the identified threshold prices.Using the current market price, national routine HPV vaccination with any currently available vaccine is unlikely cost-effective. Under a two-dose schedule, the prices of the four available HPV vaccine types cannot exceed $26-$36 per dose (44.1%-80.2% reduction from current market prices) depending on vaccine type to ensure the cost-effectiveness of the national programme. Adopting vaccination at threshold prices would require an annual increase of 72.18%-96.95% of the total annual National Immunization Programme (NIP) budget in China. A cost-saving routine vaccination programme requires vaccine prices of $5-$10 per dose (depending on vaccine type), producing a 21.38%-34.23% increase in the annual NIP budget. Adding the second dose is unlikely to be cost-effective compared to a one-dose schedule, with the threshold price approaching or even falling below zero. Rural pilot vaccination programmes require lower threshold prices compared with a national programme.Our study could inform vaccine price negotiation and thus facilitate nationwide scale-up of current HPV vaccination pilot programmes in China. The evidence may potentially be valuable to other countries facing HPV introduction barriers due to high costs. This approach may also be adapted for other contexts that involve the introduction of a pricy vaccine.CAMS Innovation Fund for Medical Sciences (CIFMS); Bill & Melinda Gates Foundation.© 2024 The Author(s).