Cost-effectiveness of screening high-risk HIV-positive men who have sex with men (MSM) and HIV-positive women for anal cancer.

Abstract

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A prospective study of anal cancer screening in HIV-positive and negative MSM

“…An early cost-effectiveness study from the United States had suggested that biennial screening using cytology to screen MSM would be associated with an incremental cost-effectiveness ratio of $13 000 per quality adjusted life years saved [16]. A costeffectiveness analysis from the United Kingdom published in 2010 concluded that many of the criteria for assessing the need for a screening programme for HIV-positive MSM were not met [17], and the authors concluded that it was unlikely that screening for anal cancer would be cost effective. In a more recent Canadian study of 400 HIV-positive MSM, using a decision analytical model, the investigators concluded that despite higher unit costs, the limitations of both HPV testing and cytology meant that anoscopy would be the most cost effective strategy [18].…”

Clinical effectiveness and cost-effectiveness of quadrivalent human papillomavirus vaccination in HIV-negative men who have sex with men to prevent recurrent high-grade anal intraepithelial neoplasia

“…The baseline prevalence of HPV16/18, LGAIN, and HGAIN and incidence of HPV types 16 and 18 in HIV-negative MSM were based on a meta-analysis [2]. The natural history parameters for disease progression and regression were based on a cost-effectiveness analysis by Czoski-Murray et al [12], who derived these estimates from two large prospective cohort studies [13, 14]. Data from Tong et al [15] were used to estimate HGAIN regression.…”

Long-Term Outcomes of Adding HPV Vaccine to the Anal Intraepithelial Neoplasia Treatment Regimen in HIV-Positive Men Who Have Sex With Men

“…Health-related utilities (defined as preference-based valuation of the health states) for HGAIN, anal cancer, and HIVpositive status (based on CD4 cell count) were obtained from a cost-effectiveness analysis published elsewhere [25] (see Supplementary Appendix Table T1.4). We further adjusted all health-related utilities by age [26].…”