Cost-effectiveness of prophylactic vaccination against human papillomavirus 16/18 for the prevention of cervical cancer: Adaptation of an existing cohort model to the situation in the Netherlands

• Published in: Vaccine Vol. 27; no. 35; pp. 4776 - 4783
• Main Authors: Rogoza, R.M, Westra, T.A, Ferko, N, Tamminga, J.J, Drummond, M.F, Daemen, T, Wilschut, J.C, Postma, M.J
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 30.07.2009; Elsevier; Elsevier Limited
• Subjects: Allergy and Immunology; Applied microbiology; Biological and medical sciences; Cervical cancer; Child; Cost-Benefit Analysis; Cost-effectiveness; Discount rates; Female; Fundamental and applied biological sciences. Psychology; HPV; Human papillomavirus; Human papillomavirus 16; Humans; Immunization; Medical sciences; Microbiology; Miscellaneous; Models, Statistical; Netherlands - epidemiology; Papillomavirus Vaccines - economics; Papillomavirus Vaccines - immunology; Sensitivity analysis; The Netherlands; Tumors; Uterine Cervical Neoplasms - economics; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - prevention & control; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Virology; Womens health; Netherlands; Europe; The Netherlands; Cost-effectiveness; Cervical cancer; HPV; Vaccination; Papovaviridae; Malignant tumor; Female genital diseases; Human papillomavirus 18; Papillomavirus; Virus; Prevention; Human papillomavirus 16; Human papillomavirus; Models; Uterine cervix diseases; Cancer; Adaptation; Cost efficiency analysis
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2009.05.085

Abstract Cervical cancer is one of the most prevalent cancers among women worldwide. Implementation of an HPV-vaccination strategy targeting the major oncogenic types 16 and 18 that cause cervical cancer is generally expected to significantly reduce the burden of cervical cancer disease. Here we estimate the costs, savings and health gains with the addition of HPV-16/18 vaccination to the already existing Dutch screening programme. In the base-case analysis, it was estimated that implementation of an HPV-16/18 vaccine would result in an incremental cost-effectiveness ratio (ICER) of €22,700 per life-year gained (LYG). In sensitivity analysis, the robustness of our finding of favourable cost-effectiveness was established. The ICER appeared sensitive to the vaccine price, discount rate and duration of vaccine-induced protection. From our results, it validly follows that immunization of 12-year-old Dutch girls against HPV-16/18 infection is a cost-effective strategy for protecting against cervical cancer.