title: An estimate of the public health impact and cost-effectiveness of universal vaccination with a 9-valent HPV vaccine in Germany.
abstract: BACKGROUND
  Since 2007, the German Standing Vaccination Committee recommends HPV vaccination for girls aged 12-17 with a 2- (Cervarix®) or 4-valent (Gardasil®) vaccine. A 9-valent vaccine (Gardasil 9®) recently received a European market authorization in 2015.
  
  
  METHODS
  A dynamic transmission model was calibrated to the German setting and used to estimate costs and QALYs associated with vaccination strategies.
  
  
  RESULTS
  Compared to the current vaccination program, the 9-valent vaccine extended to boys shows further reductions of 24% in the incidence of cervical cancer, 30% and 14% in anal cancer for males and females, as well as over a million cases of genital warts avoided after 100 years. The new strategy is associated with an ICER of 22,987€ per QALY gained, decreasing to 329€ when considering the vaccine switch for girls-only.
  
  
  CONCLUSIONS
  Universal vaccination with the 9-valent vaccine can yield significant health benefits when compared to the current program.
authors.affiliation: a Health Economics Department , Sanofi Pasteur MSD - Health Economics , Lyon , France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Largeron
authors.affiliation: b Klinikum Wolfsburg - OBGYN , Wolfsburg , Germany.
authors.forename: Karl Ulrich
authors.initials: KU
authors.lastname: Petry
authors.affiliation: c Mapi Group Ringgold - RSW&A , Uxbridge , London , UK.
authors.forename: Jorge
authors.initials: J
authors.lastname: Jacob
authors.affiliation: d Mapi Group - RSW&A , Nanterre , France.
authors.forename: Florence
authors.initials: F
authors.lastname: Bianic
authors.affiliation: d Mapi Group - RSW&A , Nanterre , France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Anger
authors.affiliation: a Health Economics Department , Sanofi Pasteur MSD - Health Economics , Lyon , France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Uhart
mesh_terms: D000293:Adolescent; D001005:Anus Neoplasms / Q000517:prevention & control / Q000821:virology; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany; D006801:Humans; D017589:Immunization Programs; D008297:Male; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000191:economics / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics; D011634:Public Health / Q000191:economics; D019057:Quality-Adjusted Life Years; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D014611:Vaccination / Q000191:economics / Q000379:methods*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cost-effectiveness; Germany; HPV; cervical cancer; vaccination