Estimación de la carga económica de las lesiones preneoplásicas y el cáncer de cuello uterino en Colombia. Implicaciones para la vacunación contra el VPH

Abstract

ObjectiveTo estimate the economic burden cervical neoplastic disease in Colombia and the effects of its prevention. MethodsThe incidence was calculated from a Markov model on the natural history of human papillomavirus (HPV) infection. Direct costs were estimated, in Colombian Pesos (COP), from cost-generating events identified in national and international guides. The monetary value of the procedures was based on current tariff manuals (ISS 2001 with a 30% adjustment and mandatory insurance (SOAT). The frequencies of use were defined by expert consensus. Screening program (cytology) and vaccination (HPV) costs were included. ResultsThe expected cases per year for IFRS (NIC) 1 (International Financial Reporting Standards), IFRS 2-3 and cancer were 177,317, 46,911, and 5,110, respectively. The cost of cytology was COP$19,070 (€9.80) and each vaccine dose cost COP$23,700 (€10.00). Screening represented the highest cost in the control of the disease (COP$126.933 million; €38.5 million). The vaccine generated an additional cost of COP$11.977 million (€3.5 million) and a saving of COP$15.969 million (€4.8 million). This latter started 20 years after introducing the strategy. To reduce the cost of the vaccination contributes to a saving and to decrease the cost of screening shortens its start-up time. ConclusionsVaccination against HPV reduces the costs of controlling uterine cervical cancer, but it requires a sustained investment for a long period of time. The reduction in the vaccine and screening costs would bring significant economic benefits, where the new, alternative technologies could play an important role.