Beyond Cervical Cancer: The Cost-Effectiveness Of Hpv Vaccination In The Netherlands

Background Human papillomavirus (HPV) vaccines and their widespread adoption have the potential to relieve a large part of the burden of cervical cancer morbidity and mortality, particularly in countries that have low screening rates or, like Japan, lack a cohesive universal screening program. An economic evaluation was conducted to assess the cost-effectiveness of introducing a bivalent HPV vaccination program in Japan from a healthcare perspective. Methods: A Markov model of the natural history of HPV infection that incorporates both vaccination and screening was developed for Japan. The modelled intervention, a bivalent HPV vaccine with a 100% lifetime vaccine efficacy and 80% vaccine coverage, given to a cohort of 12-year-old Japanese girls in conjunction with the current screening program, was compared with screening alone in terms of costs and effectiveness. A discount rate of 5% was applied to both costs and utilities where relevant. Results: Vaccination alongside screening compared with screening alone is associated with an incremental cost-effectiveness ratio (ICER) of US$20 315 per quality-adjusted-life-year gained if 80% coverage is assumed. The ICER at 5% coverage with the vaccine plus screening, compared with screening alone, is US$1158. Conclusion: The cost-effectiveness results suggest that the addition of a HPV vaccination program to Japan’s cervical cancer screening program is highly likely to prove a cost-effective way to reduce the burden of cervical cancer, precancerous lesions and HPV16/18-related diseases.

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Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis

PLoS Medicine ◽

10.1371/journal.pmed.1003534 ◽

2021 ◽

Vol 18 (3) ◽

pp. e1003534

Author(s):

Jane J. Kim ◽

Kate T. Simms ◽

James Killen ◽

Megan A. Smith ◽

Emily A. Burger ◽

...

Keyword(s):

United States ◽

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Cancer Screening ◽

Hpv Vaccination ◽

The United States ◽

The Us ◽

Age Limit ◽

The Cost

Background A nonavalent human papillomavirus (HPV) vaccine has been licensed for use in women and men up to age 45 years in the United States. The cost-effectiveness of HPV vaccination for women and men aged 30 to 45 years in the context of cervical cancer screening practice was evaluated to inform national guidelines. Methods and findings We utilized 2 independent HPV microsimulation models to evaluate the cost-effectiveness of extending the upper age limit of HPV vaccination in women (from age 26 years) and men (from age 21 years) up to age 30, 35, 40, or 45 years. The models were empirically calibrated to reflect the burden of HPV and related cancers in the US population and used standardized inputs regarding historical and future vaccination uptake, vaccine efficacy, cervical cancer screening, and costs. Disease outcomes included cervical, anal, oropharyngeal, vulvar, vaginal, and penile cancers, as well as genital warts. Both models projected higher costs and greater health benefits as the upper age limit of HPV vaccination increased. Strategies of vaccinating females and males up to ages 30, 35, and 40 years were found to be less cost-effective than vaccinating up to age 45 years, which had an incremental cost-effectiveness ratio (ICER) greater than a commonly accepted upper threshold of $200,000 per quality-adjusted life year (QALY) gained. When including all HPV-related outcomes, the ICER for vaccinating up to age 45 years ranged from $315,700 to $440,600 per QALY gained. Assumptions regarding cervical screening compliance, vaccine costs, and the natural history of noncervical HPV-related cancers had major impacts on the cost-effectiveness of the vaccination strategies. Key limitations of the study were related to uncertainties in the data used to inform the models, including the timing of vaccine impact on noncervical cancers and vaccine efficacy at older ages. Conclusions Our results from 2 independent models suggest that HPV vaccination for adult women and men aged 30 to 45 years is unlikely to represent good value for money in the US.

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Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands

BMC Infectious Diseases ◽

10.1186/1471-2334-13-75 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 16

Author(s):

Tjalke A Westra ◽

Irina Stirbu-Wagner ◽

Sara Dorsman ◽

Eric D Tutuhatunewa ◽

Edwin L de Vrij ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

The Netherlands ◽

Genital Warts ◽

Cost Effectiveness Analysis ◽

Cross Protection ◽

Human Papillomavirus Vaccination ◽

Effectiveness Analysis ◽

The Cost

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Cost-effectiveness of human papillomavirus vaccine in China: a systematic review of modelling studies

BMJ Open ◽

10.1136/bmjopen-2021-052682 ◽

2021 ◽

Vol 11 (12) ◽

pp. e052682

Author(s):

Wenchuan Shi ◽

Xiaoli Cheng ◽

Haitao Wang ◽

Xiao Zang ◽

Tingting Chen

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Study Quality ◽

The Cost

ObjectivesChina suffers from high burdens of human papillomavirus (HPV) and cervical cancer, whereas the uptake of HPV vaccine remains low. The first Chinese domestic HPV vaccine was released in 2019. However, collective evidence on cost-effectiveness of HPV vaccination in China has yet to be established. We summarised evidence on the cost-effectiveness of HPV vaccine in China.DesignSystematic review and narrative synthesisData sourcesPubMed, EMBASE, China National Knowledge Infrastructure and Wanfang Data were searched through 2 January 2021Eligibility criteria for selecting studiesCost-effectiveness studies using a modelling approach focusing on HPV vaccination interventions in the setting of China were included for review.Data extraction and synthesisWe extracted information from the selected studies focusing on cost-effectiveness results of various vaccination programmes, key contextual and methodological factors influencing cost-effectiveness estimates and an assessment of study quality.ResultsA total of 14 studies were included for review. Considerable heterogeneity was found in terms of the methodologies used, HPV vaccination strategies evaluated and study quality. The reviewed studies generally supported the cost-effectiveness of HPV vaccine in China, although some reached alternative conclusions, particularly when assessed incremental to cervical cancer screening. Cost of vaccination was consistently identified as a key determinant for the cost-effectiveness of HPV vaccination programmes.ConclusionsImplementing HPV vaccination programmes should be complemented with expanded cervical cancer screening, while the release of lower-priced domestic vaccine offers more promising potential for initiating public HPV vaccination programmes. Findings of this study contributes important evidence for policies for cervical cancer prevention in China and methodological implications for future modelling efforts.

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Exploring the cost-effectiveness of HPV vaccination in Vietnam: Insights for evidence-based cervical cancer prevention policy

Vaccine ◽

10.1016/j.vaccine.2008.05.038 ◽

2008 ◽

Vol 26 (32) ◽

pp. 4015-4024 ◽

Cited By ~ 45

Author(s):

Jane J. Kim ◽

Katie E. Kobus ◽

Mireia Diaz ◽

Meredith O'Shea ◽

Hoang Van Minh ◽

...

Keyword(s):

Cervical Cancer ◽

Cost Effectiveness ◽

Cancer Prevention ◽

Hpv Vaccination ◽

Cervical Cancer Prevention ◽

Evidence Based ◽

Prevention Policy ◽

The Cost

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Impact of Patient Adherence and Test Performance on the Cost-Effectiveness of Cervical Cancer Screening in Developing Countries

Women s Health Issues ◽

10.1016/j.whi.2009.09.001 ◽

2010 ◽

Vol 20 (1) ◽

pp. 35-42 ◽

Cited By ~ 16

Author(s):

Rebecca B. Perkins ◽

Sarah M. Langrish ◽

Linda J. Stern ◽

James F. Burgess ◽

Carol J. Simon

Keyword(s):

Cervical Cancer ◽

Developing Countries ◽

Cost Effectiveness ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Test Performance ◽

Patient Adherence ◽

The Cost

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PCVI2 SECONDARY PREVENTION AFTER PCI: THE COST-EFFECTIVENESS OF FLUVASTATIN THERAPY IN THE NETHERLANDS

Value in Health ◽

10.1016/s1098-3015(10)65794-4 ◽

2004 ◽

Vol 7 (6) ◽

pp. 688-689

Author(s):

S Chaplin ◽

P Scuffham ◽

M Aion ◽

G Boom van den

Keyword(s):

Cost Effectiveness ◽

The Netherlands ◽

Secondary Prevention ◽

The Cost

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A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program

Sexual Health ◽

10.1071/sh07043 ◽

2007 ◽

Vol 4 (3) ◽

pp. 165 ◽

Cited By ~ 77

Author(s):

Shalini Kulasingam ◽

Luke Connelly ◽

Elizabeth Conway ◽

Jane S. Hocking ◽

Evan Myers ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Hpv Vaccine ◽

Screening Program ◽

Herd Immunity ◽

Vaccination Program ◽

Catch Up ◽

The Cost ◽

Current Screening

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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