E J Dasbach1, R P Insinga, E H Elbasha. 1. Health Economic Statistics, Merck Research Laboratories, UG1C-60, PO Box 1000, North Wales, PA 19454-1099, USA. erik_dasbach@merck.com
Abstract
OBJECTIVE: To assess the potential epidemiological and economic impact of a prophylactic quadrivalent human papillomavirus (HPV) (6/11/16/18) vaccine for preventing cervical cancer, cervical intraepithelial neoplasia grades 2 and 3 (CIN2/3), CIN1 and genital warts. DESIGN: Cost-utility analysis. SETTING: UK. POPULATION: Female and male UK population 12 years or older. METHODS: We adapted a previously developed multi-HPV type dynamic transmission to compare four female vaccination strategies, routine vaccination at age 12 years, and routine vaccination at age 12 years combined with temporary catch-up vaccination at ages 12-14, 12-17 and 12-24 years. MAIN OUTCOMES MEASURES: Costs, cases avoided, incremental cost per quality-adjusted life year (QALY). RESULTS: The model projected that at year 100, each vaccination strategy could reduce the number of HPV 6/11/16/18-related cervical cancer, CIN2/3, CIN1 and genital wart cases among women by 86, 85, 79 and 89% respectively. Over 25 years, routine vaccination at age 12 years combined with a 12- to 24-year-old catch-up programme was the most effective strategy, reducing the cumulative number of cases of cervical cancer, CIN2/3, CIN1 and genital warts by 5800, 146 000, 28 000, and 1.1 million respectively. Over 100 years, the incremental cost-effectiveness ratios across all strategies ranged from pound5882 to pound11,412 per QALY gained. CONCLUSION: In the UK, a quadrivalent HPV vaccination programme that includes a catch-up strategy can reduce the incidence of cervical cancer, CIN and genital warts at a cost per QALY ratio within the range typically regarded as cost-effective.
OBJECTIVE: To assess the potential epidemiological and economic impact of a prophylactic quadrivalent human papillomavirus (HPV) (6/11/16/18) vaccine for preventing cervical cancer, cervical intraepithelial neoplasia grades 2 and 3 (CIN2/3), CIN1 and genital warts. DESIGN: Cost-utility analysis. SETTING: UK. POPULATION: Female and male UK population 12 years or older. METHODS: We adapted a previously developed multi-HPV type dynamic transmission to compare four female vaccination strategies, routine vaccination at age 12 years, and routine vaccination at age 12 years combined with temporary catch-up vaccination at ages 12-14, 12-17 and 12-24 years. MAIN OUTCOMES MEASURES: Costs, cases avoided, incremental cost per quality-adjusted life year (QALY). RESULTS: The model projected that at year 100, each vaccination strategy could reduce the number of HPV 6/11/16/18-related cervical cancer, CIN2/3, CIN1 and genital wart cases among women by 86, 85, 79 and 89% respectively. Over 25 years, routine vaccination at age 12 years combined with a 12- to 24-year-old catch-up programme was the most effective strategy, reducing the cumulative number of cases of cervical cancer, CIN2/3, CIN1 and genital warts by 5800, 146 000, 28 000, and 1.1 million respectively. Over 100 years, the incremental cost-effectiveness ratios across all strategies ranged from pound5882 to pound11,412 per QALY gained. CONCLUSION: In the UK, a quadrivalent HPV vaccination programme that includes a catch-up strategy can reduce the incidence of cervical cancer, CIN and genital warts at a cost per QALY ratio within the range typically regarded as cost-effective.
Authors: F Xavier Bosch; Claudia Robles; Mireia Díaz; Marc Arbyn; Iacopo Baussano; Christine Clavel; Guglielmo Ronco; Joakim Dillner; Matti Lehtinen; Karl-Ulrich Petry; Mario Poljak; Susanne K Kjaer; Chris J L M Meijer; Suzanne M Garland; Jorge Salmerón; Xavier Castellsagué; Laia Bruni; Silvia de Sanjosé; Jack Cuzick Journal: Nat Rev Clin Oncol Date: 2015-09-01 Impact factor: 66.675