Cost-effectiveness of quadrivalent human papillomavirus (HPV) vaccination in Mexico: a transmission dynamic model-based evaluation.
We examined the potential health outcomes and cost-effectiveness of quadrivalent human papillomavirus (HPV) 6/11/16/18 vaccination strategies in the Mexican population using a multi-HPV type dynamic transmission model. Assuming similar cervical screening practices, with or without vaccination, we examined the incremental cost-effectiveness of vaccination strategies for 12 year-old females, with or without male vaccination, and temporary age 12-24 catch-up vaccination for females or both sexes. The most effective strategy therein was vaccination of 12-year-olds, plus a temporary 12-24-year-old catch-up program covering both sexes; whereby HPV 6/11/16/18-related cervical cancer, high-grade cervical precancer, and genital wart incidence was reduced by 84-98% during year 50 following vaccine introduction. Incremental cost-effectiveness ratios in the primary analyses ranged from approximately 3000 dollars (U.S.) per quality-adjusted life year (QALY) gained for female vaccination strategies to approximately 16000 dollars /QALY for adding male vaccination with catch-up.
Department of Health Economic Statistics UG1C-60, Merck Research Laboratories, PO Box 1000, North Wales, PA 19454-1099, USA. ralph_insinga@merck.com
Ralph P
RP
Insinga
Erik J
EJ
Dasbach
Elamin H
EH
Elbasha
Andrea
A
Puig
Luz Myriam
LM
Reynales-Shigematsu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003218:Condylomata Acuminata / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico; D008875:Middle Aged; D008962:Models, Theoretical; D053918:Papillomavirus Vaccines / Q000191:economics* / Q000276:immunology; D019057:Quality-Adjusted Life Years; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000191:economics*; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control*
D053918:Papillomavirus Vaccines