Cost-effectiveness of a male catch-up human papillomavirus vaccination program in the Netherlands.
Ontology highlight
ABSTRACT:
SUBMITTER: Simons JJM
PROVIDER: S-EPMC9251567 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
Publications
Cost-effectiveness of a male catch-up human papillomavirus vaccination program in the Netherlands.
Simons Joost J M JJM Westra Tjalke A TA Postma Maarten J MJ
Preventive medicine reports 20220627
In the Netherlands, the Health Council has advised that the human papillomavirus (HPV) vaccination should be offered to both boys and girls. Additionally, boys and men up to the age of 26 years should be included in a catch-up program. In this study, we examine the cost-effectiveness of this HPV catch-up program. We used a static Markov model to estimate the amount of cancers prevented and the incremental cost-effectiveness ratio (ICER) for different scenarios. Vaccinating men from 12 until the ...[more]
Similar Datasets
Project description:BackgroundThe Dutch Human Papillomavirus (HPV) catch-up vaccination program in 2009 appeared less successful than expected. We aimed to identify the most important determinants of refusing the vaccination.MethodsTwo thousand parents of girls born in 1996 targeted for HPV vaccination received an invitation letter to participate in a questionnaire study. Two study groups were defined: the first group consisted of parents of girls who had accepted the vaccine and already received the first dose of HPV vaccination. The second group consisted of parents whose daughters were not vaccinated. The questionnaire consisted of a broad spectrum of possible determinants that were revealed after literature search and discussions with the stakeholders.ResultsFour hundred sixty nine questionnaires (24%) were returned, 307 (31%) from those who accepted and 162 (16%) from those who declined the vaccine. The decision not to accept the vaccine was largely determined by: (i) perception that the information provided by the government about the vaccine was limited or biased (OR 13.27); (ii) limited trust, that the government would stop the vaccination program if there were serious side effects (OR 9.95); (iii) lack of knowledge about the effectiveness of the vaccine (OR 7.67); (iv) concerns about the side effects of the vaccine (OR 4.94); (v) lack of conviction that HPV can be extremely harmful (OR 3.78); (vi) perception that the government is strongly influenced by vaccine producers (OR 3.54); and (vii) religious convictions (OR 2.18).ConclusionsThis study revealed several determinants for HPV vaccination uptake after implementation of the HPV vaccine for adolescent girls. These determinants should be taken into consideration in order to successfully implement HPV vaccination into National Immunization Programs.
| S-EPMC3461412 | biostudies-literature
Project description:BackgroundSince 2006, the US Centers for Disease Control and Prevention has recommended hepatitis A (HepA) vaccination routinely for children aged 12-23months to prevent hepatitis A virus (HAV) infection. However, a substantial proportion of US children are unvaccinated and susceptible to infection. We present results of economic modeling to assess whether a one-time catch-up HepA vaccination recommendation would be cost-effective.MethodsWe developed a Markov model of HAV infection that followed a single cohort from birth through death (birth to age 95years). The model compared the health and economic outcomes from catch-up vaccination interventions for children at target ages from two through 17years vs. outcomes resulting from maintaining the current recommendation of routine vaccination at age one year with no catch-up intervention.ResultsOver the lifetime of the cohort, catch-up vaccination would reduce the total number of infections relative to the baseline by 741 while increasing doses of vaccine by 556,989. Catch-up vaccination would increase net costs by $10.2million, or $2.38 per person. The incremental cost of HepA vaccine catch-up intervention at age 10years, the midpoint of the ages modeled, was $452,239 per QALY gained. Across age-cohorts, the cost-effectiveness of catch-up vaccination is most favorable at age 12years, resulting in an Incremental Cost-Effectiveness Ratio of $189,000 per QALY gained.ConclusionsGiven the low baseline of HAV disease incidence achieved by current vaccination recommendations, our economic model suggests that a catch-up vaccination recommendation would be less cost-effective than many other vaccine interventions, and that HepA catch-up vaccination would become cost effective at a threshold of $50,000 per QALY only when incidence of HAV rises about 5.0 cases per 100,000 population.
| S-EPMC5582969 | biostudies-literature
Project description:We describe a simplified model, based on the current economic and health effects of human papillomavirus (HPV), to estimate the cost-effectiveness of HPV vaccination of 12-year-old girls in the United States. Under base-case parameter values, the estimated cost per quality-adjusted life year gained by vaccination in the context of current cervical cancer screening practices in the United States ranged from $3,906 to $14,723 (2005 US dollars), depending on factors such as whether herd immunity effects were assumed; the types of HPV targeted by the vaccine; and whether the benefits of preventing anal, vaginal, vulvar, and oropharyngeal cancers were included. The results of our simplified model were consistent with published studies based on more complex models when key assumptions were similar. This consistency is reassuring because models of varying complexity will be essential tools for policy makers in the development of optimal HPV vaccination strategies.
| S-EPMC2600200 | biostudies-literature
Project description:UnlabelledLiver disease and liver cancer associated with childhood-acquired chronic hepatitis B are leading causes of death among adults in China. Despite expanded newborn hepatitis B vaccination programs, approximately 20% of children under age 5 years and 40% of children aged 5 to 19 years remain unprotected from hepatitis B. Although immunizing them will be beneficial, no studies have examined the cost-effectiveness of hepatitis B catch-up vaccination in an endemic country like China. We examined the cost-effectiveness of a hypothetical nationwide free hepatitis B catch-up vaccination program in China for unvaccinated children and adolescents aged 1 to 19 years. We used a Markov model for disease progression and infections. Cost variables were based on data published by the Chinese Ministry of Health, peer-reviewed Chinese and English publications, and the GAVI Alliance. We measured costs (2008 U.S. dollars and Chinese renminbi), quality-adjusted life years, and incremental cost-effectiveness from a societal perspective. Our results show that hepatitis B catch-up vaccination for children and adolescents in China is cost-saving across a range of parameters, even for adolescents aged 15 to 19 years old. We estimate that if all 150 million susceptible children under 19 were vaccinated, more than 8 million infections and 65,000 deaths due to hepatitis B would be prevented.ConclusionThe adoption of a nationwide free catch-up hepatitis B vaccination program for unvaccinated children and adolescents in China, in addition to ongoing efforts to improve birth dose and newborn vaccination coverage, will be cost-saving and can generate significant population-wide health benefits. The success of such a program in China could serve as a model for other endemic countries.
| S-EPMC3245734 | biostudies-literature
Project description:ObjectivesThe objective of this study is to assess the cost utility of the implementation of the human papillomavirus (HPV) vaccination programme in Tunisia in addition to the current cytology screening strategy. This study is very important to guide health policy decision-makers and to help them allocate their scarce healthcare resources.DesignWe used a previously described Markov model on the Online Cost Effectiveness Analysis tool programmed with R Software. The Markov cohort model was used to simulate the natural history of HPV infection and cervical cancer for a cohort of 100 000 females aged from 10 to 84 years. The model was calibrated with Tunisian parameters to calculate the long-term health benefits and costs of different cervical cancer preventive strategies in Tunisia.Outcome measuresThe primary outcome was the incremental cost-effectiveness ratio (ICER) of the implementation of HPV vaccination to the current cytology screening strategy to fight against cervical cancer. The ICER was calculated per life-years saved and per quality-adjusted life-year (QALY) gained, expressed in 2020 US$. Thresholds were fixed at one to three times the gross domestic product (GDP). One-way sensitivity analyses were carried out concerning the coverage rate of the cytology screening and vaccination as well as for the vaccination cost and doses.ResultsCompared with screening alone, the combined strategy predicted an ICER of US$1920.8 year of life saved and US$2239.3/QALY which is still lower than the GDP per capita of Tunisia in 2020 (US$3319). Sensitivity analysis showed that the cost-effectiveness of adding vaccination to the existing screening programme did not exceed the GDP per capita by varying the cost per dose upwards to US$45 (ICER would be US$2910/QALY) and vaccination coverage up to 100% (ICER of US$3245/QALY). However, the combined strategy exceeds the GDP per capita threshold when the cytological screening coverage rises to 70%, causing the ICER to rise to US$4787/QALY.ConclusionThis study showed that compared with screening alone, the implementation of HPV vaccination in addition to the current cytology screening programme in Tunisia would be considered cost-effective on the basis of the threshold GDP per capita. Improvement of the current screening programme itself also remains important and provides further potential to achieve optimal cervical cancer prevention strategies.
| S-EPMC11624740 | biostudies-literature
Project description:Vaccination can reduce the public health and economic burden of human papillomavirus (HPV)-associated diseases. In 2023, the Italian national immunization program (NIP) was updated to include HPV vaccination of females ≤26 and males ≤18 years. However, the cost-effectiveness of this update along with proposals to include additional cohorts is unknown. This study evaluates the cost-effectiveness of different HPV vaccination strategies in Italy over a 100-year period, using a published dynamic transmission model with Italy-specific input data. We modeled vaccination of the primary cohort (11 years of age) for 100 years, alone and supplemented with vaccination of additional cohorts for 5-100 years. We found that vaccination of the primary adolescent cohort resulted in substantial, sustained decreases in the incidence and mortality rates of all HPV-related cancers, but smaller, transient decreases in genital warts and recurrent respiratory papillomatosis. Adding supplementary vaccination of additional cohorts for 5-10 years had minor additional public health benefits, while continuing any of the modeled supplementary vaccination strategies for 100 years resulted in more substantial incremental benefits. For example, implementing the 2023-2025 NIP strategy for 100 years averted an additional 21,495 cases of cervical cancer compared to vaccination of the primary cohort alone. All supplementary vaccination strategies that were continued for 10 or 100 years were cost-effective compared to vaccination of the primary cohort alone at a willingness-to-pay threshold of €40,000 per quality-adjusted life year (QALY) gained. The benefits deriving from vaccinating additional cohorts should be considered when developing and updating NIPs.
| S-EPMC11917173 | biostudies-literature
Project description:BackgroundAfrica has some of the highest cervical cancer incidence and mortality rates globally. Burkina Faso launched a human papillomavirus (HPV) vaccination programme for 9-year-old girls in 2022 with support from Gavi, the Vaccine Alliance (Gavi). An economic evaluation of HPV vaccination is required to help sustain investment and inform decisions about optimal HPV vaccine choices.MethodsWe used a proportionate outcomes static cohort model to evaluate the potential impact and cost-effectiveness of HPV vaccination for 9-year-old girls over a ten-year period (2022-2031) in Burkina Faso. The primary outcome measure was the cost (2022 US$) per disability-adjusted life year (DALY) averted from a limited societal perspective (including all vaccine costs borne by the government and Gavi, radiation therapy costs borne by the government, and all other direct medical costs borne by patients and their families). We evaluated four vaccines (CERVARIX®, CECOLIN®, GARDASIL-4®, GARDASIL-9®), comparing each to no vaccination (and no change in existing cervical cancer screening and treatment strategies) and to each other. We combined local estimates of HPV type distribution, healthcare costs, vaccine coverage and costs with GLOBOCAN 2020 disease burden data and clinical trial efficacy data. We ran deterministic and probabilistic uncertainty analyses.ResultsHPV vaccination could prevent 37-72% of cervical cancer cases and deaths. CECOLIN® had the most favourable cost-effectiveness (cost per DALY averted < 0.27 times the national gross domestic product [GDP] per capita). When cross-protection was included, CECOLIN® remained the most cost-effective (cost per DALY averted < 0.20 times the national GDP per capita), but CERVARIX® provided greater health benefits (66% vs. 48% reduction in cervical cancer cases and deaths) with similar cost-effectiveness (cost per DALY averted < 0.28 times the national GDP per capita, with CECOLIN® as the comparator). We estimated the annual cost of the vaccination programme at US$ 2.9, 4.1, 4.4 and 19.8 million for CECOLIN®, GARDASIL-4®, CERVARIX® and GARDASIL-9®, respectively. A single dose strategy reduced costs and improved cost-effectiveness by more than half.ConclusionHPV vaccination is cost-effective in Burkina Faso from a limited societal perspective. A single dose strategy and/or alternative Gavi-supported HPV vaccines could further improve cost-effectiveness.
| S-EPMC10693094 | biostudies-literature
Project description:ObjectiveTo evaluate the impact of catch-up human papillomavirus (HPV) vaccination on conization rates in France in a large population-based study.MethodsWe conducted a retrospective real-life cohort study on data collected prospectively by French National Health Insurance. Echantillon généralistes des bénéficiaires (EGB) is a database composed of demographic and health care utilization data for a 1/97th sample of the French population. We extracted data about all women born between 1983 and 1991, corresponding to the catch-up population (vaccination after 14 years old) at the time of implementation of HPV vaccination. The primary outcome was the occurrence of conization (all types of procedures) compared between vaccinated and non-vaccinated women.ResultsThe cohort consisted of 42,452 women. Vaccination coverage (at least one dose) was low (9.8%, n = 4,129), but increased with time from vaccine implementation, from 0% in the 1983 cohort to 31% in the 1991 cohort. The conization rate was 1% for the overall population. The risk of conization for women between the ages of 19 and 30 years was reduced in the vaccinated group with a Hazard Ratio (HR) of 0.59 (95% CI[0.39-0.90]; p = 0.043).ConclusionsWith a 10-year follow-up, catch-up HPV vaccination is associated with risk reduction of conization between the ages of 19 and 30.
| S-EPMC8916646 | biostudies-literature
Project description:BackgroundIn the United States, the routine age for human papillomavirus (HPV) vaccination is 11 to 12 years, with catch-up vaccination through age 26 years for women and 21 years for men. U.S. vaccination policy on use of the 9-valent HPV vaccine in adult women and men is being reviewed.ObjectiveTo evaluate the added population-level effectiveness and cost-effectiveness of extending the current U.S. HPV vaccination program to women aged 27 to 45 years and men aged 22 to 45 years.DesignThe analysis used HPV-ADVISE (Agent-based Dynamic model for VaccInation and Screening Evaluation), an individual-based transmission dynamic model of HPV infection and associated diseases, calibrated to age-specific U.S. data.Data sourcesPublished data.Target populationWomen aged 27 to 45 years and men aged 22 to 45 years in the United States.Time horizon100 years.PerspectiveHealth care sector.Intervention9-valent HPV vaccination.Outcome measuresHPV-associated outcomes prevented and cost-effectiveness ratios.Results of base-case analysisThe model predicts that the current U.S. HPV vaccination program will reduce the number of diagnoses of anogenital warts and cervical intraepithelial neoplasia of grade 2 or 3 and cases of cervical cancer and noncervical HPV-associated cancer by 82%, 80%, 59%, and 39%, respectively, over 100 years and is cost saving (vs. no vaccination). In contrast, extending vaccination to women and men aged 45 years is predicted to reduce these outcomes by an additional 0.4, 0.4, 0.2, and 0.2 percentage points, respectively. Vaccinating women and men up to age 30, 40, and 45 years is predicted to cost $830 000, $1 843 000, and $1 471 000, respectively, per quality-adjusted life-year gained (vs. current vaccination).Results of sensitivity analysisResults were most sensitive to assumptions about natural immunity and progression rates after infection, historical vaccination coverage, and vaccine efficacy.LimitationUncertainty about the proportion of HPV-associated disease due to infections after age 26 years and about the level of herd effects from the current HPV vaccination program.ConclusionThe current HPV vaccination program is predicted to be cost saving. Extending vaccination to older ages is predicted to produce small additional health benefits and result in substantially higher incremental cost-effectiveness ratios than the current recommendation.Primary funding sourceCenters for Disease Control and Prevention.
| S-EPMC7217714 | biostudies-literature
Project description:We used transmission-dynamic modeling to estimate the added effectiveness of vaccinating multiple cohorts of females (12-26 years) in Australia compared with the theoretical introduction of routine-only (12-13 years) vaccination. Our results suggest that vaccinating multiple cohorts produced markedly faster direct/herd effects, and it added benefits that last for 20-70 years. Furthermore, the number needed to vaccinate to prevent 1 anogential warts (AGW) case or cervical cancer (CC) was similar for routine + catch-up (AGW = 9.9, CC = 678) and routine-only vaccination (AGW = 9.9, CC = 677), thus providing similar levels of efficiency per person vaccinated.
| S-EPMC5853481 | biostudies-literature