TY - JOUR

T1 - Human papillomavirus transmission and cost-effectiveness of introducing quadrivalent HPV vaccination in Denmark

AU - Olsen, Jens

AU - Jepsen, Martin Rudbeck

PY - 2010/4

Y1 - 2010/4

N2 - Objectives: The objective of this study was to simulate human papillomavirus (HPV) infection in a heterosexual population and subsequently analyze the incremental costs and effects of introducing a vaccination program against HPV types 6, 11, 16, and 18 in Denmark compared with screening alone. Methods: The analysis was performed in two phases. First, an agent-based transmission model was developed that described the HPV transmission without and with HPV vaccination. Second, an analysis of the incremental costs and effects was performed. The results of prevalence estimates of HPV, genital warts, cervical intraepithelial neoplasia (CIN1-3), and cervical cancer in the model simulations before and after introduction of HPV vaccination were extrapolated to the Danish population figures. Incremental costs and effects were then estimated. Future costs and effects were discounted. Results: Cost-effectiveness ratios for annual vaccination of 12-year-old girls, with a vaccination rate of 70 percent without a catch-up program, were estimated at approximately €1,917 per quality-adjusted life-year (QALY, 3 percent discount rate) and €10,846/QALY (5 percent discount rate), given a 62-year time horizon. Conclusions: A vaccination program would incur extra vaccination costs but would save treatment costs and improve both quality of life and survival.

AB - Objectives: The objective of this study was to simulate human papillomavirus (HPV) infection in a heterosexual population and subsequently analyze the incremental costs and effects of introducing a vaccination program against HPV types 6, 11, 16, and 18 in Denmark compared with screening alone. Methods: The analysis was performed in two phases. First, an agent-based transmission model was developed that described the HPV transmission without and with HPV vaccination. Second, an analysis of the incremental costs and effects was performed. The results of prevalence estimates of HPV, genital warts, cervical intraepithelial neoplasia (CIN1-3), and cervical cancer in the model simulations before and after introduction of HPV vaccination were extrapolated to the Danish population figures. Incremental costs and effects were then estimated. Future costs and effects were discounted. Results: Cost-effectiveness ratios for annual vaccination of 12-year-old girls, with a vaccination rate of 70 percent without a catch-up program, were estimated at approximately €1,917 per quality-adjusted life-year (QALY, 3 percent discount rate) and €10,846/QALY (5 percent discount rate), given a 62-year time horizon. Conclusions: A vaccination program would incur extra vaccination costs but would save treatment costs and improve both quality of life and survival.

KW - Cervical cancer

KW - Cost-effectiveness

KW - Genital warts

KW - HPV transmission

KW - HPV vaccination

UR - http://www.scopus.com/inward/record.url?scp=77953554172&partnerID=8YFLogxK

U2 - 10.1017/S0266462310000085

DO - 10.1017/S0266462310000085

M3 - Journal article

C2 - 20392322

AN - SCOPUS:77953554172

VL - 26

SP - 183

EP - 191

JO - International Journal of Technology Assessment in Health Care

JF - International Journal of Technology Assessment in Health Care

SN - 0266-4623

IS - 2

ER -