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Cost-effectiveness analysis of the nine-valent HPV vaccine in Italy

Mennini, FS; Bonanni, P; Bianic, F; de Waure, C; Baio, G; Plazzotta, G; Uhart, M; ... Largeron, N; + view all (2017) Cost-effectiveness analysis of the nine-valent HPV vaccine in Italy. Cost Effectiveness and Resource Allocation , 15 , Article 11. 10.1186/s12962-017-0073-8. Green open access

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Abstract

BACKGROUND: In Italy HPV vaccination with the quadrivalent vaccine (Gardasil(®)) is offered actively and free of charge to girls aged 12 since 2007. A nine-valent vaccine (Gardasil 9(®)) received the European market authorization in 2015 to protect, with only 2 doses, against around 90% of all HPV positive cancers, over 80% of high-grade precancerous lesions and 90% of genital warts caused by HPV types 6/11. METHODS: A dynamic transmission model simulating the natural history of HPV-infections was calibrated to the Italian setting and used to estimate costs and QALYs associated with vaccination strategies. The analyses compared two strategies with the nine-valent vaccine (cervical cancer screening and vaccination in girls only or vaccination in boys and girls) to four alternative strategies (cervical cancer screening and vaccination with quadrialent vaccine in girls only, in both boys and girls, with bivalent vaccine in girls and screening strategy only). The National Health Service perspective was considered. CONCLUSION: The switch to the nine-valent vaccine in Italy can further reduce the burden associated to cervical cancer and HPV-related diseases and is highly cost-effective. RESULTS: Compared to the current vaccination program with quadrivalent vaccine, the nine-valent vaccine in a programme including girls and boys shows further reductions of 17% in the incidence of cervical cancer, 35 and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new technology is associated with an ICER of 10,463€ per QALY gained in universal vaccination, decreasing to 4483€ when considering the vaccine switch for girls-only.

Type: Article
Title: Cost-effectiveness analysis of the nine-valent HPV vaccine in Italy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12962-017-0073-8
Publisher version: http://dx.doi.org/10.1186/s12962-017-0073-8
Language: English
Additional information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Cervical cancer, Cost-effectiveness, HPV, Italy, Vaccination
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
URI: https://discovery.ucl.ac.uk/id/eprint/1564910
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