Estimating The Cost-Effectiveness Profile of A Universal Vaccination Programme With A Nine-Valent Hpv Vaccine In Austria

Background: The cost-effectiveness of adding a human papillomavirus (HPV) vaccine to the Australian National Cervical Screening Program compared to screening alone was examined. Methods: A Markov model of the natural history of HPV infection that incorporates screening and vaccination was developed. A vaccine that prevents 100% of HPV 16/18-associated disease, with a lifetime duration of efficacy and 80% coverage offered through a school program to girls aged 12 years, in conjunction with current screening was compared with screening alone using cost (in Australian dollars) per life-year (LY) saved and quality-adjusted life-year (QALY) saved. Sensitivity analyses included determining the cost-effectiveness of offering a catch-up vaccination program to 14–26-year-olds and accounting for the benefits of herd immunity. Results: Vaccination with screening compared with screening alone was associated with an incremental cost-effectiveness ratio (ICER) of $51 103 per LY and $18 735 per QALY, assuming a cost per vaccine dose of $115. Results were sensitive to assumptions about the duration of vaccine efficacy, including the need for a booster ($68 158 per LY and $24 988 per QALY) to produce lifetime immunity. Accounting for herd immunity resulted in a more attractive ICER ($36 343 per LY and $13 316 per QALY) for girls only. The cost per LY of vaccinating boys and girls was $92 052 and the cost per QALY was $33 644. The cost per LY of implementing a catch-up vaccination program ranged from $45 652 ($16 727 per QALY) for extending vaccination to 14-year-olds to $78 702 ($34 536 per QALY) for 26-year-olds. Conclusions: These results suggest that adding an HPV vaccine to Australia’s current screening regimen is a potentially cost-effective way to reduce cervical cancer and the clinical interventions that are currently associated with its prevention via screening alone.

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An estimate of the public health impact and cost-effectiveness of universal vaccination with a 9-valent HPV vaccine in Germany

Expert Review of Pharmacoeconomics & Outcomes Research ◽

10.1080/14737167.2016.1208087 ◽

2016 ◽

Vol 17 (1) ◽

pp. 85-98 ◽

Cited By ~ 18

Author(s):

Nathalie Largeron ◽

Karl Ulrich Petry ◽

Jorge Jacob ◽

Florence Bianic ◽

Delphine Anger ◽

...

Keyword(s):

Public Health ◽

Cost Effectiveness ◽

Hpv Vaccine ◽

Health Impact ◽

Universal Vaccination ◽

Public Health Impact ◽

The Public

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Assessment of the cost–effectiveness of a quadrivalent HPV vaccine in Norway using a dynamic transmission model

Expert Review of Pharmacoeconomics & Outcomes Research ◽

10.1586/14737167.8.5.491 ◽

2008 ◽

Vol 8 (5) ◽

pp. 491-500 ◽

Cited By ~ 20

Author(s):

Erik J Dasbach ◽

Nathalie Largeron ◽

Elamin H Elbasha

Keyword(s):

Cost Effectiveness ◽

Hpv Vaccine ◽

Transmission Model ◽

Quadrivalent Hpv Vaccine ◽

Dynamic Transmission Model ◽

The Cost

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Cost-effectiveness and value-based prices of the 9-valent human papillomavirus vaccine for the prevention of cervical cancer in China: an economic modelling analysis

BMJ Open ◽

10.1136/bmjopen-2019-031186 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031186 ◽

Cited By ~ 3

Author(s):

Y Jiang ◽

Weiyi Ni ◽

Jing Wu

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Hpv Vaccine ◽

Cost Effective ◽

Sensitivity Analyses ◽

Base Case ◽

Economic Modelling ◽

Current Price ◽

The Cost

ObjectivesTo evaluate the cost-effectiveness of the 9-valent human papillomavirus (HPV) vaccine for the prevention of cervical cancer in China.DesignHealth economic modelling using the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model populated with China-specific data.SettingIndividual cervical cancer prevention in China using the 9-valent HPV vaccine from the perspective of private sector purchasers in relation to receiving other HPV vaccines and not receiving vaccination for 16-year-old girls in China who had not been previously infected with HPV.ParticipantsNot applicable.InterventionsVaccination using the 9-valent, the quadrivalent and the bivalent vaccines.Primary outcome measureIncremental costs per disability-adjusted life year (DALY) prevented.ResultsIn the base case, the incremental costs per DALY prevented were, respectively, US$35 000 and US$50 455 compared with the quadrivalent and the bivalent vaccines, both of which were above the cost-effective threshold of US$25 920/DALY prevented. To be cost-effective in these comparisons, the 9-valent vaccine should be priced at $550 and $450 for the full doses, respectively. To be highly cost-effective, the price thresholds were $435 and $335. The incremental costs per DALY prevented in relation to no vaccination was US$23 012, making the 9-valent vaccine marginally cost-effective. The results were robust in most one-way sensitivity analyses including changing vaccination age to 13 and 26 years.ConclusionsAt the current price, the 9-valent HPV vaccine is not cost-effective compared with the quadrivalent and the bivalent vaccines for young girls in China who had not been previously infected with HPV. Policymakers and clinicians should keep potential vaccine recipients informed about the economic profile of the 9-valent vaccine and carefully consider expanding its use in China at the current price.

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