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

Mennini, Francesco Saverio; Bonanni, Paolo; Bianic, F.; Waure, Chiara de; Baio, Gianluca; Plazzotta, Giacomo; Uhart, M.; Rinaldi, Alessandro; Largeron, Nathalie

doi:10.1186/s12962-017-0073-8

Cited by 37 publications

(51 citation statements)

References 39 publications

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“…[25][26][27] A later study confirmed the cost-effectiveness of 9vHPV in the United States. 28 In Europe, recent studies in Austria, 29 Germany 30 , Italy 31 and, more recently, in the UK 24 , have also shown the costeffectiveness of 9vHPV in gender-neutral vaccination scenarios.…”

Section: Discussionmentioning

confidence: 99%

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Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain

Fuente

Aguado

Martín

et al. 2019

Human Vaccines & Immunotherapeutics

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Human papillomavirus (HPV) is one of the main causes of infection-related cancer. The bivalent vaccine (2vHPV) (16/18) and quadrivalent (6/11/16/18) HPV vaccine (4vHPV) have been included in the Spanish vaccination calendar since 2007. The new nonavalent HPV vaccine (9vHPV), approved in Europe in 2015, includes nine HPV types 6/11/16/18/31/33/45/52/58 and has been available in Spain since May 2017. Our study aims to estimate the epidemiological impact and the cost-effectiveness of a girls-only and a gender-neutral vaccination program with 9vHPV compared to the current vaccination program in Spain. A dynamic transmission model simulating the natural history of HPV infections was calibrated to the Spanish setting and applied to estimate costs and quality-adjusted life years (QALYs) associated with vaccination strategies using a payer perspective and a 100-year time horizon. A girls-only vaccination strategy at age 12 years with 9vHPV was found to be a cost-effective strategy compared with 4vHPV (incremental cost-effectiveness ratio (ICER) of €7,718 per QALY). Compared with girls-only vaccination with 4vHPV, gender-neutral vaccination with 9vHPV was associated with further reductions of up to 28.5% in the incidence of cervical intraepithelial neoplasia (CIN) 2/3 and 17.1% in the incidence of cervical cancer, as well as with a 14.0% reduction in cervical cancer mortality. Furthermore, a gender-neutral vaccination program with 9vHPV could potentially be cost-effective considering some parameters as head and neck protection or discount rates, leading to a reduction in the burden of HPVrelated diseases in both sexes in the Spanish population.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, the results can be reasonably considered conservative estimates. Finally, our model does not allow running a probabilistic sensitivity analysis; so, as the previously published adaptations [29][30][31] , only deterministic sensitivity analysis was carried out.…”

Section: Discussionmentioning

confidence: 99%

Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain

Fuente

Aguado

Martín

et al. 2019

Human Vaccines & Immunotherapeutics

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“…To overcome this problem, we recommend the use of a nine-valent vaccine (9vHPV) instead of the bivalent and quadrivalent vaccines. The 9vHPV vaccine contains type 6,11,16,18,31,33,45,52, and 58 which was approved by the FDA in December 2014, and by the European Medicines Agency (EMA) in June 2015 [100].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Genotype Distribution of Genital Human Papillomavirus Infection in Female Sex Workers in the World: A Systematic Review and Meta-Analysis

Farahmand

Moghoofei

Dorost

et al. 2020

Preprint

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Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world. Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta. Results: Sixty-two studies involving 21402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.60% (95% confidence interval (CI): 38.58%-46.71%). HPV-16 (10.16%, 95% CI: 8.20%–12.51%), HPV-52 (7.98%, 95% CI: 5.91%–10.70%), and HPV-53 (6.01%, 95% CI: 4.40%–8.15%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.64% (95% CI: 36.12%-51.46%) and 41.97% (95% CI: 37.28%-46.81%), respectively. Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.

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“…Particularly when industry sponsored, these models may be considered exercises in marketing rather than science, mainly aimed at supporting prices held high on the basis of various heterogeneous assumptions and estimates open to the authors' discretion and manufacturers' influence [14]; these 'patchwork' analyses are eventually misleading and of scant utility for public policy purposes. The three European economic models focussed on the nonavalent vaccine to support universal coverage that we found in the literature 1 [17][18][19] are no exception and seem more like a further (unnecessary) confirmation of this (mal)practice. All sponsored and co-authored by at least two employees of the manufacturer, the three studies exploited the same American model and concluded that the nonavalent vaccine is cost effective at prices largely over €100 per dose in Austria, Germany and Italy, ignoring in their analyses the much lower prices awarded in domestic tenders for the two other HPV vaccines.…”

Section: Policy Implicationsmentioning

confidence: 76%