A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer
Version of Record online: 13 APR 2015
© 2015 American Cancer Society
Volume 121, Issue 11, pages 1785–1792, June 1, 2015
How to Cite
Graham, D. M., Isaranuwatchai, W., Habbous, S., de Oliveira, C., Liu, G., Siu, L. L. and Hoch, J. S. (2015), A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. Cancer, 121: 1785–1792. doi: 10.1002/cncr.29111
- Issue online: 20 MAY 2015
- Version of Record online: 13 APR 2015
- Manuscript Accepted: 5 SEP 2014
- Manuscript Revised: 18 AUG 2014
- Manuscript Received: 23 JUN 2014
- economic issues and research/treatment;
- head and neck cancer;
- statistical methods and models;
- mathematical methods and models;
- computer methods and models
Many western countries have established female human papillomavirus (HPV) vaccination programs for the prevention of cervical cancer. The quadrivalent HPV vaccine (HPV4) has proven efficacy against additional HPV-related disease in both sexes, but the cost effectiveness of male HPV vaccination remains controversial. To assess the cost effectiveness of male HPV vaccination in Canada with respect to oropharyngeal cancer (OPC), the authors performed a preliminary cost-effectiveness analysis.
After an extensive literature review regarding HPV-related OPC in Canadian males, health care costs and clinical effectiveness estimates were obtained. A Markov model was used to compare the potential costs and effectiveness of HPV4 versus no vaccination among boys aged 12 years. A theoretical cohort based on a Canadian population of 192,940 boys aged 12 years in 2012 was assumed to apply the model. A 3-month cycle length was used with a “lifetime” time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables, including the vaccine uptake rate and vaccine efficacy.
Assuming 99% vaccine efficacy and 70% uptake, HPV4 produced 0.05 more QALYs and saved $145 Canadian dollars (CAD) per individual compared with no vaccine (QALYs and costs were discounted at 5% per year). Assuming 50% vaccine efficacy and 50% uptake, HPV4 produced 0.023 more QALYs and saved $42 CAD. The results indicated that HPV4 in males may potentially save between $8 and $28 million CAD for the theoretical cohort of 192,940 over its lifetime.
On the basis of this model, HPV vaccination for boys aged 12 years may be a cost-effective strategy for the prevention of OPC in Canada. Cancer 2015;121:1785–1792. © 2015 American Cancer Society.