Cost-effectiveness analysis of human papillomavirus-vaccination programs to prevent cervical cancer in Austria.

OBJECTIVE The study predicts long-term cervical cancer related population health and economic effects of introducing the HPV-vaccination for 12-year-old girls (and boys) in addition to current screening compared with screening only. METHOD Health effects are predicted by a dynamic transmission model. Model results are used to calculate incremental cost-effectiveness ratios (ICER) in euro per life year gained (LYG) for a time-horizon between 2008 and 2060 from a public payer and a societal perspective. RESULTS Vaccination of girls results a discounted ICER of euro 64,000/LYG and euro 50,000/LYG from a payer's and societal perspectives respectively. The additional vaccination of boys increases the ICER to euro 311,000 and euro 299,000/LYG respectively. Results were most sensitive to vaccination price, discount rate and time-horizon. CONCLUSION HPV-vaccination for girls should be cost-effective when adopting a longer time-horizon and a societal perspective. Applying a shorter time frame and a payer's perspective or vaccinating boys may not be cost-effective without reducing the vaccine price.

[1]  G. Sanders,et al.  Evaluating Human Papillomavirus Vaccination Programs , 2004, Emerging infectious diseases.

[2]  Obstetric HPV vaccination for the prevention of cervical cancer. , 2010, Nursing for Women s Health.

[3]  Philippe Vielh,et al.  Cross sectional study of conventional cervical smear, monolayer cytology, and human papillomavirus DNA testing for cervical cancer screening , 2003, BMJ : British Medical Journal.

[4]  Sue J Goldie,et al.  Health and economic implications of HPV vaccination in the United States. , 2008, The New England journal of medicine.

[5]  R. Burk,et al.  Natural history of cervicovaginal papillomavirus infection in young women , 1998 .

[6]  Erik J. Dasbach,et al.  Model for Assessing Human Papillomavirus Vaccination Strategies , 2007, Emerging infectious diseases.

[7]  E. Dasbach,et al.  Cost-effectiveness of quadrivalent human papillomavirus (HPV) vaccination in Mexico: a transmission dynamic model-based evaluation. , 2007, Vaccine.

[8]  Uwe Siebert,et al.  When should decision-analytic modeling be used in the economic evaluation of health care? , 2003, The European Journal of Health Economics, formerly: HEPAC.

[9]  P. De Wals,et al.  The potential cost-effectiveness of prophylactic human papillomavirus vaccines in Canada. , 2007, Vaccine.

[10]  Mark Jit,et al.  Economic evaluation of human papillomavirus vaccination in the United Kingdom , 2008, BMJ : British Medical Journal.

[11]  T. Waldhoer,et al.  Prevalence of self-reported cervical cancer screening and impact on cervical cancer mortality in Austria. , 1999, Wiener klinische Wochenschrift.

[12]  S. Herbst Wissenschaftler/innen fordern Neubewertung der HPV-Impfung und ein Ende der irreführenden Informationen , 2009 .

[13]  G. Garnett,et al.  HPV-vaccination for the prevention of cervical cancer in Austria: a model based long-term prognosis of cancer epidemiology , 2010, Journal of Public Health.

[14]  Shalini L Kulasingam,et al.  Adding a quadrivalent human papillomavirus vaccine to the UK cervical cancer screening programme: A cost-effectiveness analysis , 2008, Cost effectiveness and resource allocation : C/E.

[15]  Milton C Weinstein,et al.  Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. , 2004, Journal of the National Cancer Institute.

[16]  P. Mathevet,et al.  Cost-effectiveness analysis of the introduction of a quadrivalent human papillomavirus vaccine in France , 2008, International Journal of Technology Assessment in Health Care.

[17]  A. Muñoz,et al.  Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of Colombian women with normal cytological results. , 2004, The Journal of infectious diseases.

[18]  J. Ferlay,et al.  Globocan 2000 : cancer incidence, mortality and prevalence worldwide , 2001 .

[19]  M. Gold Cost-effectiveness in health and medicine , 2016 .

[20]  M. Drummond,et al.  Health Care Technology: Effectiveness, Efficiency and Public Policy@@@Methods for the Economic Evaluation of Health Care Programmes , 1988 .

[21]  三澤吉雄 In Canada … , 1980, Current History.

[22]  K. Jansen,et al.  Detection of HPV in Norwegian cervical biopsy specimens with type-specific PCR and reverse line blot assays. , 2006, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[23]  Karen M Kuntz,et al.  Multiparameter calibration of a natural history model of cervical cancer. , 2007, American journal of epidemiology.

[24]  Shalini L Kulasingam,et al.  Potential health and economic impact of adding a human papillomavirus vaccine to screening programs. , 2003, JAMA.

[25]  Grazyna Adamiak,et al.  Methods for the economic evaluation of health care programmes, 3rd ed , 2006 .

[26]  Xavier Castellsagué,et al.  Against which human papillomavirus types shall we vaccinate and screen? the international perspective , 2004, International journal of cancer.

[27]  Mark Sculpher,et al.  Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report. , 2009, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[28]  Gillian D. Sanders,et al.  Cost Effectiveness of a Potential Vaccine for Human papillomavirus , 2003, Emerging infectious diseases.

[29]  Jeremy D Goldhaber-Fiebert,et al.  Cost-effectiveness of HPV 16, 18 vaccination in Brazil. , 2007, Vaccine.