title: A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France.
abstract: The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14-23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544-1,020 million vs. EUR 177-538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306-380 million savings (37-56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13-33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71-89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types.
authors.affiliation: SPMSD SNC; Lyon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bresse
authors.forename: Marjorie
authors.initials: M
authors.lastname: Adam
authors.forename: Nathalie
authors.initials: N
authors.lastname: Largeron
authors.forename: Stephane
authors.initials: S
authors.lastname: Roze
authors.forename: Rémi
authors.initials: R
authors.lastname: Marty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000191:economics* / Q000276:immunology*; D014611:Vaccination / Q000191:economics / Q000379:methods*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: France; HPV vaccine; cost-consequence; human papillomavirus
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):467-75
references.pmid: 15734974
references.citation: Gynecol Oncol. 2011 Jun 1;121(3):514-21
references.pmid: 21334734
references.citation: N Engl J Med. 2007 May 10;356(19):1928-43
references.pmid: 17494926
references.citation: Lancet Oncol. 2012 Jan;13(1):89-99
references.pmid: 22075171
references.citation: Emerg Infect Dis. 2008 Feb;14(2):244-51
references.pmid: 18258117
references.citation: J Med Econ. 2010;13(2):324-38
references.pmid: 20504110
references.citation: Cancer Prev Res (Phila). 2009 Oct;2(10):868-78
references.pmid: 19789295
references.citation: Head Neck Oncol. 2010 Sep 01;2:22
references.pmid: 20809978
references.citation: Head Neck Oncol. 2010 Jun 29;2:15
references.pmid: 20587061
references.citation: Gynecol Obstet Fertil. 2007 Feb;35(2):107-13
references.pmid: 17270482
references.citation: Eur J Cancer. 2009 Oct;45(15):2632-9
references.pmid: 19709878
references.citation: Rev Epidemiol Sante Publique. 2010 Oct;58(5):331-8
references.pmid: 20869182
references.citation: Br J Cancer. 2006 Dec 4;95(11):1459-66
references.pmid: 17117182
references.citation: Int J Public Health. 2011 Apr;56(2):153-62
references.pmid: 21110060
references.citation: Vaccine. 2007 Jul 20;25(29):5399-408
references.pmid: 17561316
references.citation: Obstet Gynecol. 2003 Apr;101(4):645-52
references.pmid: 12681865
references.citation: Gynecol Obstet Fertil. 2006 Nov;34(11):1036-42
references.pmid: 17070085
references.citation: BMC Cancer. 2013 Jan 08;13:10
references.pmid: 23298365
references.citation: J Clin Pathol. 2009 Oct;62(10):870-8
references.pmid: 19706632
references.citation: Int J Cancer. 2009 Apr 1;124(7):1626-36
references.pmid: 19115209
references.citation: Int J Technol Assess Health Care. 2008 Winter;24(1):10-9
references.pmid: 18218164
references.citation: Otolaryngol Clin North Am. 2012 Jun;45(3):671-94, viii-ix
references.pmid: 22588043
references.citation: Vaccine. 2010 Aug 31;28(38):6247-55
references.pmid: 20643092
references.citation: Vaccine. 2011 Jul 18;29(32):5245-9
references.pmid: 21616117
references.citation: Euro Surveill. 2012 Sep 13;17(37):
references.pmid: 22995436
references.citation: Vaccine. 2011 Apr 27;29(19):3610-6
references.pmid: 21382486
references.citation: Arch Otolaryngol Head Neck Surg. 2004 Jun;130(6):711-6
references.pmid: 15210551
references.citation: BMJ. 2010 Jul 20;341:c3493
references.pmid: 20647284
references.citation: Eur J Dermatol. 2001 Nov-Dec;11(6):598-603; quiz 604
references.pmid: 11701422
references.citation: Int J Pediatr Otorhinolaryngol. 2010 Jan;74(1):7-14
references.pmid: 19800138
references.citation: J Infect Dis. 2009 Mar 15;199(6):805-14
references.pmid: 19199546
references.citation: Lancet Infect Dis. 2011 Jan;11(1):39-44
references.pmid: 21067976
references.citation: Lancet Oncol. 2012 Jan;13(1):100-10
references.pmid: 22075170
references.citation: Lancet Oncol. 2011 Sep;12(9):862-70
references.pmid: 21865087
references.citation: J Infect Dis. 2009 Apr 1;199(7):926-35
references.pmid: 19236279
references.citation: Bull Cancer. 2007 Feb;94(2):219-24
references.pmid: 17337390
references.citation: Pharmacoeconomics. 2012 Jan;30(1):1-16
references.pmid: 22201520
references.citation: Int J STD AIDS. 2010 Jun;21(6):381-5
references.pmid: 20606216
references.citation: Vaccine. 2006 Aug 31;24 Suppl 3:S3/35-41
references.pmid: 16950016
references.citation: Vaccine. 2010 Oct 4;28(42):6858-67
references.pmid: 20713101
references.citation: BMJ. 2011 Sep 27;343:d5775
references.pmid: 21951758
references.citation: Sex Transm Dis. 2007 Jul;34(7):503-7
references.pmid: 17325621
references.citation: Lancet Oncol. 2005 May;6(5):271-8
references.pmid: 15863374
references.citation: Lancet. 2009 Dec 12;374(9706):1975-85
references.pmid: 19962185
references.citation: J Clin Virol. 2012 Mar;53(3):239-43
references.pmid: 22209292
references.citation: Sex Transm Infect. 2011 Dec;87(7):544-7
references.pmid: 21970896
references.citation: BMC Cancer. 2012 Jan 20;12:30
references.pmid: 22260541
references.citation: N Engl J Med. 2007 May 10;356(19):1915-27
references.pmid: 17494925
references.citation: Eur J Public Health. 2010 Apr;20(2):213-9
references.pmid: 19864366