title: The cost-effectiveness of male HPV vaccination in the United States.
abstract: BACKGROUND
  The objective of this study was to estimate the cost-effectiveness of adding human papillomavirus (HPV) vaccination of 12-year-old males to a female-only vaccination program for ages 12-26 years in the United States.
  
  
  METHODS
  We used a simplified model of HPV transmission to estimate the reduction in the health and economic burden of HPV-associated diseases in males and females as a result of HPV vaccination. Estimates of the incidence, cost-per-case, and quality-of-life impact of HPV-associated health outcomes were based on the literature. The HPV-associated outcomes included were: cervical intraepithelial neoplasia (CIN); genital warts; juvenile-onset recurrent respiratory papillomatosis (RRP); and cervical, vaginal, vulvar, anal, oropharyngeal, and penile cancers.
  
  
  RESULTS
  The cost-effectiveness of male vaccination depended on vaccine coverage of females. When including all HPV-associated outcomes in the analysis, the incremental cost per quality-adjusted life year (QALY) gained by adding male vaccination to a female-only vaccination program was $23,600 in the lower female coverage scenario (20% coverage at age 12 years) and $184,300 in the higher female coverage scenario (75% coverage at age 12 years). The cost-effectiveness of male vaccination appeared less favorable when compared to a strategy of increased female vaccination coverage. For example, we found that increasing coverage of 12-year-old girls would be more cost-effective than adding male vaccination even if the increased female vaccination strategy incurred program costs of $350 per additional girl vaccinated.
  
  
  CONCLUSIONS
  HPV vaccination of 12-year-old males might potentially be cost-effective, particularly if female HPV vaccination coverage is low and if all potential health benefits of HPV vaccination are included in the analysis. However, increasing female coverage could be a more efficient strategy than male vaccination for reducing the overall health burden of HPV in the population.
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. HChesson@cdc.gov
authors.forename: Harrell W
authors.initials: HW
authors.lastname: Chesson
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015233:Models, Statistical; D030361:Papillomavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics* / Q000276:immunology; D011788:Quality of Life; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000191:economics* / Q000379:methods*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines