The epidemiological and economic impact of a quadrivalent human papillomavirus vaccine (6/11/16/18) in the UK.
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.


METHODS
Cost-utility analysis.


METHODS
UK.


METHODS
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.


METHODS
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 pound5882 to pound11,412 per QALY gained.


CONCLUSIONS
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.
Dasbach
E J
EJ
Health Economic Statistics, Merck Research Laboratories, UG1C-60, PO Box 1000, North Wales, PA 19454-1099, USA. erik_dasbach@merck.com
Insinga
R P
RP
Elbasha
E H
EH
D000293:Adolescent; D000328:Adult; D003218:Condylomata Acuminata / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000191:economics; D053918:Papillomavirus Vaccines; D019057:Quality-Adjusted Life Years; D006113:United Kingdom / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D002578:Uterine Cervical Dysplasia / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*
D053918:Papillomavirus Vaccines