世界卫生组织(WHO)开发了一种成本计算工具,宫颈癌预防和控制成本(C4P)工具,估计宫颈癌的综合成本,低收入和中等收入国家的二级和三级预防。该工具在坦桑尼亚联合共和国进行了试点,一个宫颈癌高发国家,2020年每10万名女性中62.5例。本文介绍了成本计算工具方法以及坦桑尼亚试点的结果。
C4P工具估计子宫颈癌预防和控制计划的增量成本。它估计财政成本(政府的货币成本)和经济成本(机会成本)。对于飞行员来说,研究小组收集了2020-2024年对14岁女孩进行人乳头瘤病毒(HPV)疫苗接种以及扩大宫颈癌筛查(乙酸目视检查和HPV-DNA检测)和女性治疗的费用和方案假设数据.假设疫苗接种覆盖率将如何在5年内增加,并通过卫生人员培训和基础设施加强发展额外的筛查和治疗能力。
2020-2024年综合计划的总财务和经济成本预计为6800万美元和1.24亿美元。分别。一名接受HPV疫苗完全免疫的女孩的经济成本估计分别为6.68美元和17.31美元,虽然每位接受宫颈癌筛查的女性的费用是,平均而言,分别为4.02美元和5.83美元;癌前治疗为6.44美元和9.37美元,分别为101美元和107美元用于诊断浸润性癌症,分别。治疗和管理浸润性癌症的费用从门诊姑息治疗的7.05美元和7.83美元到放疗的800.21美元和893.80美元不等。分别。
C4P成本计算工具可以帮助国家宫颈癌计划估计所需的货币资源,以及通过初级、二级和三级预防。
The World Health Organization (WHO) has developed a
costing tool, the Cervical Cancer Prevention and Control
Costing (C4P) tool, to estimate the comprehensive cost of cervical cancer primary, secondary and tertiary prevention in low- and middle-income countries. The tool was piloted in the United Republic of Tanzania, a country with a high incidence of cervical cancer with 62.5 cases per 100,000 women in 2020. This paper presents the
costing tool methods as well as the results from the pilot in Tanzania.
The C4P tool estimates the incremental costs of cervical cancer prevention and control programmes. It estimates the financial (monetary costs to the government) and economic costs (opportunity costs). For the pilot, the study team collected data on costs and programme assumptions for human papillomavirus (HPV) vaccination of 14-year-old girls and scaling up of cervical cancer screening (visual inspection with acetic acid and HPV-DNA testing) and treatment for women for 2020-2024. Assumptions were made on how vaccination coverage would increase over the 5 years as well as developing additional screening and treatment capacity through health personnel training and infrastructure strengthening.
The total financial and economic costs of the comprehensive programme during 2020-2024 are projected to be US$68 million and US$124 million, respectively. The financial and economic costs of a fully immunized girl with HPV vaccine are estimated to be US$6.68 and US$17.31, respectively, while the costs per woman screened for cervical cancer are, on average, US$4.02 and US$5.83, respectively; US$6.44 and US$9.37 for pre-cancer treatment, respectively; and US$101 and US$107 for diagnosis of invasive cancer, respectively. The cost of treating and managing invasive cancer range from US$7.05 and US$7.83 for outpatient palliative care to US$800.21 and US$893.80 for radiotherapy, respectively.
The C4P
costing tool can assist national cervical cancer programmes to estimate monetary resources needed as well as opportunity costs of reducing national cervical cancer incidence through primary, secondary and tertiary prevention.