Assessing the introduction of universal human papillomavirus vaccination for preadolescent girls in The Netherlands

Boot, Hein J.; Wallenburg, Iris; Melker, Hester E. de; Mangen, Marie-Josée J.; Gerritsen, Annette; Maas, Nicoline At van der; Berkhof, Johannes; Meijer, Chris J.L.M.; Kimman, Tjeerd G.

doi:10.1016/j.vaccine.2007.05.061

Cited by 42 publications

(27 citation statements)

References 86 publications

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“…Thirty-six articles including EEs focused on HPV vaccination strategies were considered eligible for analysis; 20 were then excluded, as they referred to non-EU settings. Therefore, 16 articles [18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] were eligible. One of them lacked essential methodological transparency [20], so 15 were eventually selected comprising 24 EEs since 9 articles [21, 23-26, 30, 32-34] contained two separate analyses.…”

Section: Literature Searchmentioning

confidence: 99%

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Economic evaluation of human papilloma virus vaccination in the European Union: a critical review

Koleva¹,

Compadri²,

Padula³

et al. 2011

Intern Emerg Med

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The human papilloma virus (HPV) vaccine is a new and expensive vaccine potentially effective in the prevention of a cancer. We reviewed the economic evaluations (EEs) on the vaccine in the EU to assess their potential contribution to public decision-making in a fairly homogeneous setting where HPV vaccination has been widely adopted. A literature search on PubMed selected EEs on HPV vaccines in the EU for the period 2007-2010 using the terms "HPV vaccines" and "Costs and cost analysis." Fifteen articles were eventually selected. All studies were based on modelling techniques, either "cohort" or "dynamic transmission": three were cost utility, three cost-effectiveness, and the remainder included both. The ten studies explicitly assessing one of the two vaccines were all sponsored by their manufacturer, while the five studies unrelated to the vaccine type were funded by public agencies. Apart from two studies, utility estimates were always obtained from three US sources. Direct costs were always vaccination, diagnosis and treatment of related pathologies. Incremental cost-effectiveness ratio (ICER) results were less favourable when life years gained were valued rather than quality-adjusted life years, genital warts were excluded, and booster doses and extension of vaccination to men were included in the base-case analysis. All but one of the sponsored EEs recommend in favour of the vaccination strategy, which is dominant in one English study. The ICER results were very sensitive to discount rates, followed by duration of protection and vaccine price. At such an early stage, when the vaccines' efficacy have been demonstrated by well-designed studies, it is not possible (and not even reasonable) to wait for several years to measure their effectiveness; public decision-makers might benefit more from EEs designed to indicate sustainable prices using realistic estimates of crucial variables like coverage rates, rather than referring to a large number of assumptions in order to show acceptable cost-effectiveness.

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Section: Literature Searchmentioning

confidence: 99%

“…Five studies used dynamic transmission models [18,22,28,29,34], the other ten static Markov models. Three [27][28][29] did cost-utility analyses (CUA), three [18,22,31] cost-effectiveness analyses (CEA), and the remaining nine [21, 23-26, 30, 32-34] included both CUAs and CEAs (Tables 2, 3, 4).…”

Section: Setting Type Sponsorshipmentioning

confidence: 99%

Economic evaluation of human papilloma virus vaccination in the European Union: a critical review

Koleva¹,

Compadri²,

Padula³

et al. 2011

Intern Emerg Med

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“…Together, the incidence of these types of cancer that is attributable to HPV16 and 18 is around 40% of the incidence of cervical cancer. 47 Although hardly any evidence is available on this topic, it may be expected that HPV vaccination also offers protection against these types of cancer. Finally, we did not consider the benefit of protecting against HPV6 and HPV11 infections, even though 1 of the 2 available vaccines offers protection against these 2 low-risk types.…”

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confidence: 99%

HPV16/18 vaccination to prevent cervical cancer in The Netherlands: Model‐based cost‐effectiveness

Coupé

Ginkel

Melker

et al. 2008

Intl Journal of Cancer

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We evaluated the cost-effectiveness of HPV16/18 vaccination for girls aged 12 years in The Netherlands in addition to cervical cancer screening. For this purpose, we developed a simulation model that describes the relation between each of the high-risk human papillomavirus (hrHPV) types and cervical disease, allowing the occurrence of multiple type-specific infections. Model parameters were derived from Dutch cohort studies, including a large population-based screening trial, and from the national cervical cancer registry. The model satisfactorily reproduced Dutch data on HPV infection and the presence of cervical lesions. For our base-case scenario in which 85% of the girls aged 12 years were vaccinated against types 16/18 (95% efficacy, lifelong protection), the model predicted a decrease of 60% in the number of cervical cancer cases and cervical cancer deaths indicating that substantial health benefits can be achieved. Health savings were robust against changes in the vaccine efficacy (varied from 85% to 98%) but savings showed a substantial reduction when the efficacy started waning 10 years after vaccination. The discounted costs per qualityadjusted life year (QALY) were € 19,500/QALY (range € 11,000 to € 25,000/QALY) and lied near the cost-effectiveness threshold of € 20,000/QALY used in The Netherlands. The simulations further showed that vaccination cannot replace screening because vaccination without screening was less effective than screening in preventing cancer in women over 40 years of age. In conclusion, our model results support the implementation of HPV16/18 vaccination in young women in addition to cervical cancer screening. ' 2008 Wiley-Liss, Inc.Key words: simulation model; human papillomavirus; cervical cancer; vaccination Infection with high-risk human papillomavirus (hrHPV) is the necessary cause of cervical cancer.1 Recently, prophylactic vaccines have come available that protect against infection with the oncogenic HPV types 16 and 18.2,3 HPV 16 and/or 18 (HPV 16/ 18) is present in 60-80% of all cervical cancer cases.4,5 Therefore, mass vaccination may have a substantial impact on the burden of cervical cancer, even in countries with organized cervical screening. The safety and efficacy of HPV16/18 vaccination has been demonstrated in several large randomized trials. 3,6,7 For women without detectable HPV16/18 DNA, an efficacy of 90-98% against HPV16/18 positive cervical intraepithelial neoplasia grade 2 and 3 (CIN2/3) was reported. In addition, some evidence for cross-protection against other HPV types was reported.3 Because of the limited follow-up, long-term efficacy is still uncertain but within the first 5 years no reduction in efficacy was observed and HPV type-specific antibody levels remained at a high level. 8To decide whether or not to introduce nationwide HPV16/18 vaccination, insight into the cost-effectiveness of vaccination is needed in addition to information on safety and efficacy. For this purpose, simulation models have been developed that predict country-specific costs...

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“…Ambas incluyen los tipos virales más frecuentes en CCU como son HPV 16 y 18 21 . Además estas vacunas presentan reactividad cruzada incompleta con los genotipos virales de alto riesgo oncogénico HPV 31 y 45 [22][23][24] .…”

Section: N V E S T I G a C I ó Nunclassified

Detección y tipificación de virus papiloma humano en adenocarcinoma de cuello uterino mediante reverse line blot, Región de La Araucanía, Chile

Ili

et al. 2009

Rev. méd. Chile

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Assessing the introduction of universal human papillomavirus vaccination for preadolescent girls in The Netherlands

Cited by 42 publications

References 86 publications

Economic evaluation of human papilloma virus vaccination in the European Union: a critical review

Economic evaluation of human papilloma virus vaccination in the European Union: a critical review

HPV16/18 vaccination to prevent cervical cancer in The Netherlands: Model‐based cost‐effectiveness

Detección y tipificación de virus papiloma humano en adenocarcinoma de cuello uterino mediante reverse line blot, Región de La Araucanía, Chile

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