Cost-effectiveness of a potential vaccine for human papillomavirus

• Published in: Emerging infectious diseases Vol. 9; no. 1; pp. 37 - 48
• Main Authors: Sanders, Gillian D, Taira, Al V
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01-01-2003; Centers for Disease Control and Prevention
• Subjects: Cervix neoplasms; Child; Cost-Benefit Analysis; Female; Human papillomavirus; Humans; Markov Chains; Models, Theoretical; Papillomaviridae - immunology; Papillomavirus Infections - economics; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; Quality of Life; Quality-Adjusted Life Years; Risk Factors; United States; Uterine Cervical Neoplasms - economics; Uterine Cervical Neoplasms - prevention & control; Vaccination; Vaccines; Viral Vaccines - economics; Viral Vaccines - immunology; United States
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid0901.020168

Human papillomavirus (HPV) infection, usually a sexually transmitted disease, is a risk factor for cervical cancer. Given the substantial disease and death associated with HPV and cervical cancer, development of a prophylactic HPV vaccine is a public health priority. We evaluated the cost-effectiveness of vaccinating adolescent girls for high-risk HPV infections relative to current practice. A vaccine with a 75% probability of immunity against high-risk HPV infection resulted in a life-expectancy gain of 2.8 days or 4.0 quality-adjusted life days at a cost of $246 relative to current practice (incremental cost effectiveness of $22,755/quality-adjusted life year [QALY]). If all 12-year-old girls currently living in the United States were vaccinated, >1,300 deaths from cervical cancer would be averted during their lifetimes. Vaccination of girls against high-risk HPV is relatively cost effective even when vaccine efficacy is low. If the vaccine efficacy rate is 35%, the cost effectiveness increases to $52,398/QALY. Although gains in life expectancy may be modest at the individual level, population benefits are substantial.