Public health impact and cost effectiveness of routine and catch-up vaccination of girls and women with a nine-valent HPV vaccine in Japan: a model-based study

Palmer, Cody; Tobe, Keisuke; Abe, Machiko; Elbasha, Elamin H.

doi:10.1186/s12879-020-05632-0

Cited by 26 publications

(18 citation statements)

References 26 publications

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“…The study estimated that 9vHPV vaccination would result in additional overall treatment cost-savings of Singapore dollars (SGD) 61.8 million (USD 46.4 million) and an ICER of SGD 929/QALY (USD 679/QALY), thus highlighting that 9vHPV vaccination is very cost-effective compared with 2vHPV vaccination [ 19 ]. The cost-effectiveness demonstrated in our analysis is also consistent with analyses of other HPV vaccination programs, including those analyzed for the 9vHPV vaccine [ 18 , 19 , 31 – 33 ].…”

Section: Discussionsupporting

confidence: 83%

The impact and cost-effectiveness of 9-valent human papillomavirus vaccine in adolescent females in Hong Kong

Cheung

Cheng²,

Hsu³

et al. 2021

Cost Eff Resour Alloc

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Introduction In Hong Kong (HK), a single-cohort vaccination program for 10–12-year-old girls with the 9-valent human papillomavirus (HPV) vaccine (9vHPV; types 6/11/16/18/31/33/45/52/58) has been launched. This study assessed the public health impact and cost-effectiveness of implementing routine 9vHPV vaccination (12-year-olds) with or without catch-up 9vHPV vaccination (13–18-year-olds) in HK. Methods The health impact and costs of implementing routine 9vHPV vaccination with or without catch-up vaccination over a 100-year time horizon were evaluated using a validated HPV-type transmission dynamic model adapted to the HK population; analyses were performed from a healthcare payer perspective. Routine vaccination (12-year-old girls) and catch-up vaccination (13–18 years) assumed vaccine coverage rates of 70% (base case) and 30%, respectively. The model also assumed herd immunity, lifelong vaccine protection, a discount rate of 3%, and a cost per dose of HK dollars (HKD) 858 [United States dollars (USD) 110] and HKD 1390 (USD 179) for the 2-valent HPV (2vHPV) and 9vHPV vaccines, respectively. HPV disease-related incidence and the incremental cost-effectiveness ratio (ICER) per quality-adjusted-life-year (QALY) were estimated. Cost-effectiveness was determined at a ceiling threshold of HK dollars (HKD) 382,046 (USD 49,142) or 1.0 times the gross domestic product per capita of HK. Results Compared with routine 9vHPV alone, routine plus catch-up 9vHPV is projected to reduce cervical cancer incidence by 3.4%. Routine plus catch-up 9vHPV will also reduce genital warts incident cases for males/females by 2.6%/5.4%. The incremental cost-effectiveness ratios were HKD 29,911 (USD 3847)/quality-adjusted life-year (QALY) for routine plus catch-up 9vHPV versus routine 9vHPV alone and HKD 25,524 (USD 3283)/QALY for routine 9vHPV alone versus screening only. Sensitivity analyses indicated that routine plus catch-up 9vHPV compared with routine 9vHPV alone remained cost-effective at coverage rates of 30% and 90%. Conclusions This analysis predicts that the current HK vaccination strategy can be considered cost-effective and will provide maximum health benefit. These results support addition of the routine 9vHPV vaccine with or without catch-up 9vHPV vaccination to the regional vaccination program in HK.

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Section: Discussionsupporting

confidence: 83%

The impact and cost-effectiveness of 9-valent human papillomavirus vaccine in adolescent females in Hong Kong

Cheung

Cheng²,

Hsu³

et al. 2021

Cost Eff Resour Alloc

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“…As the national HPV immunization program has been disrupted by the pandemic, there is a need to put in place catch-up vaccination programs to ensure the closure of the large gaps created by COVID-19. A model-based study conducted in Japan showed that over a 100-year time horizon, there will be earlier and greater reductions in cervical cancer incidence through catch-up HPV vaccination programs where up to 484,248 cases of cervical cancer will be avoided over a 100-year span from 2021 to 2121 ( 16 ). Furthermore, this study also showed that there would be a significant reduction of HPV-related diseases such as anogenital warts where an additional 364,721 cases could be prevented by continuing the routine HPV vaccination in both men and women ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…A model-based study conducted in Japan showed that over a 100-year time horizon, there will be earlier and greater reductions in cervical cancer incidence through catch-up HPV vaccination programs where up to 484,248 cases of cervical cancer will be avoided over a 100-year span from 2021 to 2121 ( 16 ). Furthermore, this study also showed that there would be a significant reduction of HPV-related diseases such as anogenital warts where an additional 364,721 cases could be prevented by continuing the routine HPV vaccination in both men and women ( 16 ). The modal based was calculated with presumption of 42% HPV vaccine coverage among young women.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on the national HPV immunization program in Malaysia

Rao

Kampan

Chew

et al. 2022

Front. Public Health

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In Malaysia, the HPV immunization program has been introduced since 2010 as part of the national immunization plan for female students aged 13 years old. It was a very successful immunization program with good responses from students and parents until the start of COVID-19 pandemic in 2020. The COVID-19 pandemic caused the schools to be closed and resulted about 225000 female students aged 13 years old either missed their vaccination or have incomplete doses of HPV vaccination in 2020 and 2021. This could possibly lead to an increase in cases of cervical cancer and genital warts in the upcoming years. Hence, a wellorganized catch-up HPV vaccination program is vital in ensuring the aim of achieving zero HPV-related infections in the future.

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“…Genderneutral program was also considered to be a cost-effective choice in France and Italy [17,21]. On the other hand, there are several studies concluding that girls-only program is more cost-effective [16,[22][23][24][25]. For instance, Cody et al compared different vaccination strategies of 4-valent or 9valent HPV vaccines in Japan.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, Cody et al compared different vaccination strategies of 4-valent or 9-valent HPV vaccines in Japan. They found that the most cost-effective strategy was the vaccination program with 9-valent vaccine targeting 12-16 years old girls together with a temporary catch-up program [16]. Similarly, Kim et al showed that increasing the coverage in girls was more effective and less costly than including boys in a low-resource setting [22].…”

Section: Introductionmentioning

confidence: 99%

A two-sex model of human papillomavirus infection: Vaccination strategies and a case study

Gao

Martcheva

Miao

et al. 2021

Preprint

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Vaccination is effective in preventing human papillomavirus (HPV) infection. It still remains debatable whether males should be included in a vaccination program and unclear how to allocate the vaccine in genders to achieve the maximum benefits. In this paper, we use a two-sex model to assess HPV vaccination strategies and use the data from Guangxi Province in China as a case study. Both mathematical analysis and numerical simulations show that the basic reproduction number, an important indicator of the transmission potential of the infection, achieves its minimum when the priority of vaccination is given to the gender with a smaller recruit rate. Given a fixed amount of vaccine, splitting the vaccine evenly usually leads to a larger basic reproduction number and a higher prevalence of infection. Vaccination becomes less effective in reducing the infection once the vaccine amount exceeds the smaller recruit rate of the two genders. In the case study, we estimate the basic reproduction number is 1.0333 for HPV 16/18 in people aged 15-55. The minimal bivalent HPV vaccine needed for the disease prevalence to be below 0.05% is 24050 per year, which should be given to females. However, with this vaccination strategy it would require a very long time and a large amount of vaccine to achieve the goal. In contrast with allocating the same vaccine amount every year, we find that a variable vaccination strategy with more vaccine given in the beginning followed by less vaccine in later years can save time and total vaccine amount. The variable vaccination strategy illustrated in this study can help to better distribute the vaccine to reduce the HPV prevalence. Although this work is for HPV infection and the case study is for a province in China, the model, analysis and conclusions may be applicable to other sexually transmitted diseases in other regions or countries.

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Public health impact and cost effectiveness of routine and catch-up vaccination of girls and women with a nine-valent HPV vaccine in Japan: a model-based study

Cited by 26 publications

References 26 publications

The impact and cost-effectiveness of 9-valent human papillomavirus vaccine in adolescent females in Hong Kong

The impact and cost-effectiveness of 9-valent human papillomavirus vaccine in adolescent females in Hong Kong

The impact of the COVID-19 pandemic on the national HPV immunization program in Malaysia

A two-sex model of human papillomavirus infection: Vaccination strategies and a case study

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