Skip to main content Accessibility help
×
Home

Human papillomavirus transmission and cost-effectiveness of introducing quadrivalent HPV vaccination in Denmark

  • Jens Olsen (a1) and Martin Rudbeck Jepsen (a2)

Abstract

Objectives: The objective of this study was to simulate human papillomavirus (HPV) infection in a heterosexual population and subsequently analyze the incremental costs and effects of introducing a vaccination program against HPV types 6, 11, 16, and 18 in Denmark compared with screening alone.

Methods: The analysis was performed in two phases. First, an agent-based transmission model was developed that described the HPV transmission without and with HPV vaccination. Second, an analysis of the incremental costs and effects was performed. The results of prevalence estimates of HPV, genital warts, cervical intraepithelial neoplasia (CIN1–3), and cervical cancer in the model simulations before and after introduction of HPV vaccination were extrapolated to the Danish population figures. Incremental costs and effects were then estimated. Future costs and effects were discounted.

Results: Cost-effectiveness ratios for annual vaccination of 12-year-old girls, with a vaccination rate of 70 percent without a catch-up program, were estimated at approximately €1,917 per quality-adjusted life-year (QALY, 3 percent discount rate) and €10,846/QALY (5 percent discount rate), given a 62-year time horizon.

Conclusions: A vaccination program would incur extra vaccination costs but would save treatment costs and improve both quality of life and survival.

Copyright

References

Hide All
1. Bergeron, C, Largeron, N, McAllister, R, Mathevet, P, Remy, V. Cost-effectiveness analysis of the introduction of a quadrivalent human papillomavirus vaccine in France. Int J Technol Assess Health Care. 2008;24:1019.
2. Burchell, AN, Richardson, H, Mahmud, SM, et al. Modeling the sexual transmissibility of human papillomavirus infection using stochastic computer simulation and empirical data from a cohort study of young women in Montreal, Canada. Am J Epidemiol. 2006;163:534543.
3. Canadian Agency for Drugs and Technologies in Health. Guidelines for the economic evaluation of health technologies: Canada. 3rd ed. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2006.
4. Clifford, GM, Rana, RK, Franceschi, S, et al. Human papillomavirus genotype distribution in low-grade cervical lesions: Comparison by geographic region and with cervical cancer. Cancer Epidemiol Biomarkers Prev. 2005;14:11571164.
5. Elbasha, EH, Dasbach, EJ, Insinga, RP. Model for assessing human papillomavirus vaccination strategies. Emerg Infect Dis. 2007;13:2841.
6. European Medicines Agency. Gardasil-H-C-703-II-06. Annex 1. Summary of Product Characteristics. London: European Medicines Agency; 2008.
7. Hu, D, Goldie, S. The economic burden of noncervical human papillomavirus disease in the United States. Am J Obstet Gynecol. 2008;198:500507.
8. Jakobsen, AK, Engelholm, SA, Knudsen, JB. [Cervix cancer]. Ugeskr Laeger. 2002;164:30593062.
9. Jit, M, Choi, YH, Edmunds, WJ. Economic evaluation of human papillomavirus vaccination in the United Kingdom. BMJ. 2008;337:a769.
10. Kim, SY, Goldie, SJ. Cost-effectiveness analyses of vaccination programmes: A focused review of modelling approaches. Pharmacoeconomics. 2008;26:191215.
11. Kjaer, SK, Tran, TN, Sparen, P, et al. The burden of genital warts: A study of nearly 70,000 women from the general female population in the 4 Nordic countries. J Infect Dis. 2007;196:14471454.
12. Lacey, CJ, Lowndes, CM, Shah, KV. Chapter 4: Burden and management of non-cancerous HPV-related conditions: HPV-6/11 disease. Vaccine. 2006;24 (Suppl 3):S35S41.
13. Langley, PC, Langley-Hawthorne, C, Rash, R. Data on file report. A retrospective analysis of treatment patterns and costs in external genital warts in Danish dermatology clinics. 3M Pharmaceuticals; 2001.
14. Langley, PC, Langley-Hawthorne, C, Rash, R. Study report. A retrospective analysis of treatment patterns and costs of external genital warts in general practice in Denmark. 3M Pharmaceuticals; 2001.
15. Ministry of Health and Prevention [Ministeriet for Sundhed og Forebyggelse]. Agreement between the government (Liberal and Conservative parties), Danish People's Party, Social-Liberal Party and New Alliance about: New initiatives in the health care sector (1st March 2008 [Aftale mellem regeringen (Venstre og Konservative), Dansk Folkeparti, Det Radikale Venstre og Ny Alliance om: Nye initiativer på sundhedsområdet (1. marts 2008)]. Denmark: Ministry of Health and Prevention; 2008.
16. Monsonego, J, Breugelmans, JG, Bouee, S, et al. [Anogenital warts incidence, medical management and costs in women consulting gynaecologists in France]. Gynecol Obstet Fertil. 2007;35:107113.
17. National Board of Health. Liquid-based cytology and conventional Pap smear used in cervical cancer screening in Denmark – a health technology assessment [Væskebaseret teknik og udstryningsteknik anvendt til screening for livmoderhalskræft i Danmark—en medicinsk teknologivurdering]. Copenhagen: National Board of Health; 2005.
18. National Board of Health. Reduction in the risk of cervical cancer by vaccination against human papillomavirus (HPV) – a health technology assessment. Copenhagen: National Board of Health, Danish Centre for Health Technology Assessment; January 20, 2007. Report No: 9(1).
19. National Board of Health. The cancer registry and the causes of death registry. Copenhagen: National Board of Health; 2008.
20. Olsson, SE, Villa, LL, Costa, RL, et al. Induction of immune memory following administration of a prophylactic quadrivalent human papillomavirus (HPV) types 6/11/16/18 L1 virus-like particle (VLP) vaccine. Vaccine. 2007;25:49314939.
21. Parkin, DM, Bray, F, Ferlay, J, Pisani, P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74108.
22. Smith, JS, Lindsay, L, Hoots, B, et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: A meta-analysis update. Int J Cancer. 2007;121:621632.
23. The UK Collaborative Group for HIV and STI Surveillance. Testing times. HIV and other sexually transmitted infections in the United Kingdom: 2007. London: Health Protection Agency, Centre for Infections; November 2007.
24. Usher, C, Tilson, L, Olsen, J, et al. Cost-effectiveness of human papillomavirus vaccine in reducing the risk of cervical cancer in Ireland due to HPV types 16 and 18 using a transmission dynamic model. Vaccine. 2008;26:56545661.

Keywords

Type Description Title
UNKNOWN
Supplementary materials

Olsen supplementary material
Supplementary figure 1

 Unknown (122 KB)
122 KB

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed