HPV vaccine strategies: the cost of HPV and the choice of vaccine

Morris, Sheldon R.

doi:10.1136/sti.2008.034793

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Here, we estimated that a €6.70 (7%) price differential, in favour of the quadrivalent HPV vaccine, resulted in equal ICERs. This justifiable price difference between both vaccines estimated in the present study is slightly different from that found in other studies [31]. For example, Jit et al .…”

Section: Discussioncontrasting

confidence: 99%

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Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands

et al. 2013

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BackgroundInfection with HPV 16 and 18, the major causative agents of cervical cancer, can be prevented through vaccination with a bivalent or quadrivalent vaccine. Both vaccines provide cross-protection against HPV-types not included in the vaccines. In particular, the bivalent vaccine provides additional protection against HPV 31, 33, and 45 and the quadrivalent vaccine against HPV31. The quadrivalent vaccine additionally protects against low-risk HPV type 6 and 11, responsible for most cases of genital warts. In this study, we made an analytical comparison of the two vaccines in terms of cost-effectiveness including the additional benefits of cross-protection and protection against genital warts in comparison with a screening-only strategy.MethodsWe used a Markov model, simulating the progression from HPV infection to cervical cancer or genital warts. The model was used to estimate the difference in future costs and health effects of both HPV-vaccines separately.ResultsIn a cohort of 100,000 women, use of the bivalent or quadrivalent vaccine (both at 50% vaccination coverage) reduces the cervical cancer incidence by 221 and 207 cases, corresponding to ICERs of €17,600/QALY and €18,900/QALY, respectively. It was estimated that the quadrivalent vaccine additionally prevents 4390 cases of genital warts, reducing the ICER to €16,300/QALY. Assuming a comparable willingness to pay for cancer and genital warts prevention, the difference in ICERs could justify a slightly higher price (~7% per dose) in favor of the quadrivalent vaccine.ConclusionsClearly, HPV vaccination has been implemented for the prevention of cervical cancer. From this perspective, use of the bivalent HPV vaccine appears to be most effective and cost-effective. Including the benefits of prevention against genital warts, the ICER of the quadrivalent HPV vaccine was found to be slightly more favourable. However, current decision-making on the introduction of HPV is driven by the primary cervical cancer outcome. New vaccine tenders could consider the benefits of cross-protection and the benefits of genital warts, which requires more balanced decision-making.

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Section: Discussioncontrasting

confidence: 99%

“…estimated that the bivalent vaccine should be approximately 25% less expensive [32]. Indeed, even larger discrepancies have been reported [31,33]. The difference between our study and those of others can be explained by various factors.…”

Section: Discussioncontrasting

confidence: 76%

Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands

et al. 2013

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“…The choice between the two currently licensed HPV vaccines has been subject to intense debate in countries such as Australia and the UK with central vaccine procurement 6263 64 65 66 Yet few published studies have tried to estimate the price difference for the two vaccines to be equally cost effective.…”

Section: Discussionmentioning

confidence: 99%

Comparing bivalent and quadrivalent human papillomavirus vaccines: economic evaluation based on transmission model

Jit¹,

Hughes

Choi³

2011

BMJ

106

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Objectives To compare the effect and cost effectiveness of bivalent and quadrivalent human papillomavirus (HPV) vaccination, taking into account differences in licensure indications, protection against non-vaccine type disease, protection against disease related to HPV types 6 and 11, and reported long term immunogenicity.Design A model of HPV transmission and disease previously used to inform UK vaccination policy, updated with recent evidence and expanded to include scenarios where the two vaccines differ in duration of protection, cross protection, and end points prevented. Setting United Kingdom.Population Males and females aged 12-75 years.Main outcome measure Incremental cost effectiveness ratios for both vaccines and additional cost per dose for the quadrivalent vaccine to be equally cost effective as the bivalent vaccine. ResultsThe bivalent vaccine needs to be cheaper than the quadrivalent vaccine to be equally cost effective, mainly because of its lack of protection against anogenital warts. The price difference per dose ranges from a median of £19 (interquartile range £12-£27) to £35 (£27-£44) across scenarios about vaccine duration, cross protection, and end points prevented (assuming one quality adjusted life year (QALY) is valued at £30 000 and both vaccines can prevent all types of HPV related cancers). ConclusionsThe quadrivalent vaccine may have an advantage over the bivalent vaccine in reducing healthcare costs and QALYs lost. The bivalent vaccine may have an advantage in preventing death due to cancer. However, considerable uncertainty remains about the differential benefit of the two vaccines.

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“…There are bivalent vaccines (Cervarix), quadrivalent vaccines (Gardasil-4), and a nine-valent vaccine (Gardasil 9) for preventing cervical cancer. Morris [34] suggests selecting vaccines based on the epidemiological characteristics of different regions. However, residents have the right to choose whether to receive the HPV vaccine and the type of vaccine, and their specific action strategies depend on their level of risk preference.…”

Section: Discussionmentioning

confidence: 99%

Optimal ordering strategy and budget allocation for the Covid-19 vaccination planning

Liu,

Zhu,

Wang

2024

Math. Model. Nat. Phenom.

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Abstract. During the COVID-19 pandemic, the most important thing was to control the overall infection rate. To achieve this goal, social managers can choose to use vaccines with different production cycles and therapeutic effects for epidemic prevention and control under financial budget constraints. We adopt a two-tier queueing system with reneging to characterize the operation management of COVID19 vaccine ordering and vaccination, in which a higher-efficacy vaccine queue (HQ) and a lower-efficacy vaccine queue (LQ) are employed to account for two types of vaccines service. In light of this framework, a recursive formula is proposed for deriving the infection rates of residents in both HQ and LQ. Social managers can achieve the lowest total infection rate by selecting appropriate vaccine ordering strategies under fixed service capacity, or by allocating financial budgets reasonably under the investment cost regime. Accordingly, we obtain socially optimal vaccine ordering strategies and financial budget allocation. Finally, we analyze the sensitivity of various parameters to relevant optimal strategies and discover that utilizing a mixed ordering strategy is socially optimal in most circumstances. However, in some extreme cases, ordering a single type of vaccine (higher- or lower-efficacy) may result in the lowest societal infection rate.

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HPV vaccine strategies: the cost of HPV and the choice of vaccine

Cited by 5 publications

References 14 publications

Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands

Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands

Comparing bivalent and quadrivalent human papillomavirus vaccines: economic evaluation based on transmission model

Optimal ordering strategy and budget allocation for the Covid-19 vaccination planning

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