Cost-effectiveness of a potential vaccine for human papillomavirus.
Human papillomavirus (HPV) infection, usually a sexually transmitted disease, is a risk factor for cervical cancer. Given the substantial disease and death associated with HPV and cervical cancer, development of a prophylactic HPV vaccine is a public health priority. We evaluated the cost-effectiveness of vaccinating adolescent girls for high-risk HPV infections relative to current practice. A vaccine with a 75% probability of immunity against high-risk HPV infection resulted in a life-expectancy gain of 2.8 days or 4.0 quality-adjusted life days at a cost of $246 relative to current practice (incremental cost effectiveness of $22,755/quality-adjusted life year [QALY]). If all 12-year-old girls currently living in the United States were vaccinated, >1,300 deaths from cervical cancer would be averted during their lifetimes. Vaccination of girls against high-risk HPV is relatively cost effective even when vaccine efficacy is low. If the vaccine efficacy rate is 35%, the cost effectiveness increases to $52,398/QALY. Although gains in life expectancy may be modest at the individual level, population benefits are substantial.
Sanders
Gillian D
GD
Center for Primary Care and Outcomes Research, 117 Encina Commons, Stanford University, Stanford, CA 94305-6019, USA. sanders@stanford.edu
Taira
Al V
AV
D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008390:Markov Chains; D008962:Models, Theoretical; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000191:economics / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000517:prevention & control*; D014611:Vaccination; D014765:Viral Vaccines / Q000191:economics* / Q000276:immunology
D053918:Papillomavirus Vaccines; D014765:Viral Vaccines