title: A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer.
abstract: BACKGROUND
  Many western countries have established female human papillomavirus (HPV) vaccination programs for the prevention of cervical cancer. The quadrivalent HPV vaccine (HPV4) has proven efficacy against additional HPV-related disease in both sexes, but the cost effectiveness of male HPV vaccination remains controversial. To assess the cost effectiveness of male HPV vaccination in Canada with respect to oropharyngeal cancer (OPC), the authors performed a preliminary cost-effectiveness analysis.
  
  
  METHODS
  After an extensive literature review regarding HPV-related OPC in Canadian males, health care costs and clinical effectiveness estimates were obtained. A Markov model was used to compare the potential costs and effectiveness of HPV4 versus no vaccination among boys aged 12 years. A theoretical cohort based on a Canadian population of 192,940 boys aged 12 years in 2012 was assumed to apply the model. A 3-month cycle length was used with a "lifetime" time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables, including the vaccine uptake rate and vaccine efficacy.
  
  
  RESULTS
  Assuming 99% vaccine efficacy and 70% uptake, HPV4 produced 0.05 more QALYs and saved $145 Canadian dollars (CAD) per individual compared with no vaccine (QALYs and costs were discounted at 5% per year). Assuming 50% vaccine efficacy and 50% uptake, HPV4 produced 0.023 more QALYs and saved $42 CAD. The results indicated that HPV4 in males may potentially save between $8 and $28 million CAD for the theoretical cohort of 192,940 over its lifetime.
  
  
  CONCLUSIONS
  On the basis of this model, HPV vaccination for boys aged 12 years may be a cost-effective strategy for the prevention of OPC in Canada.
authors: Princess Margaret Cancer Center, Toronto, Ontario, Canada.
authors: Donna M
authors: DM
authors: Graham
authors: Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, Ontario, Canada.
authors: Wanrudee
authors: W
authors: Isaranuwatchai
authors: Princess Margaret Cancer Center, Toronto, Ontario, Canada.
authors: Steven
authors: S
authors: Habbous
authors: Department of Social and Epidemiological Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada.
authors: Claire
authors: C
authors: de Oliveira
authors: Princess Margaret Cancer Center, Toronto, Ontario, Canada.
authors: Geoffrey
authors: G
authors: Liu
authors: Princess Margaret Cancer Center, Toronto, Ontario, Canada.
authors: Lillian L
authors: LL
authors: Siu
authors: Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, Ontario, Canada.
authors: Jeffrey S
authors: JS
authors: Hoch
mesh_terms: D002170:Canada / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D006801:Humans; D008297:Male; D008390:Markov Chains; D015233:Models, Statistical; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics
chemical_list: D053918:Papillomavirus Vaccines
keywords: computer methods and models; economic issues and research/treatment; head and neck cancer; mathematical methods and models; statistical methods and models