The epidemiological and economic impact of a quadrivalent human papillomavirus vaccine (6/11/16/18) in the UK
Article first published online: 28 JUN 2008
© 2008 Merck & Co., Inc. Journal compilation © RCOG 2008 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 115, Issue 8, pages 947–956, July 2008
How to Cite
Dasbach, E., Insinga, R. and Elbasha, E. (2008), The epidemiological and economic impact of a quadrivalent human papillomavirus vaccine (6/11/16/18) in the UK. BJOG: An International Journal of Obstetrics & Gynaecology, 115: 947–956. doi: 10.1111/j.1471-0528.2008.01743.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Accepted 10 March 2008. Published OnlineEarly 23 May 2008.
- Cervical intraepithelial neoplasia;
- cost-effectiveness analysis;
- human papillomavirus;
- uterine cervical neoplasms;
Objective To assess the potential epidemiological and economic impact of a prophylactic quadrivalent human papillomavirus (HPV) (6/11/16/18) vaccine for preventing cervical cancer, cervical intraepithelial neoplasia grades 2 and 3 (CIN2/3), CIN1 and genital warts.
Design Cost-utility analysis.
Population Female and male UK population 12 years or older.
Methods We adapted a previously developed multi-HPV type dynamic transmission to compare four female vaccination strategies, routine vaccination at age 12 years, and routine vaccination at age 12 years combined with temporary catch-up vaccination at ages 12–14, 12–17 and 12–24 years.
Main outcomes measures Costs, cases avoided, incremental cost per quality-adjusted life year (QALY).
Results The model projected that at year 100, each vaccination strategy could reduce the number of HPV 6/11/16/18-related cervical cancer, CIN2/3, CIN1 and genital wart cases among women by 86, 85, 79 and 89% respectively. Over 25 years, routine vaccination at age 12 years combined with a 12- to 24-year-old catch-up programme was the most effective strategy, reducing the cumulative number of cases of cervical cancer, CIN2/3, CIN1 and genital warts by 5800, 146 000, 28 000, and 1.1 million respectively. Over 100 years, the incremental cost-effectiveness ratios across all strategies ranged from £5882 to £11,412 per QALY gained.
Conclusion In the UK, a quadrivalent HPV vaccination programme that includes a catch-up strategy can reduce the incidence of cervical cancer, CIN and genital warts at a cost per QALY ratio within the range typically regarded as cost-effective.