Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain
Human papillomavirus (HPV) is one of the main causes of infection-related cancer. The bivalent vaccine (2vHPV) (16/18) and quadrivalent (6/11/16/18) HPV vaccine (4vHPV) have been included in the Spanish vaccination calendar since 2007. The new nonavalent HPV vaccine (9vHPV), approved in Europe in 20...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-08-01
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| Series: | Human Vaccines & Immunotherapeutics |
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| Online Access: | http://dx.doi.org/10.1080/21645515.2018.1560770 |
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| author | Jesús De La Fuente Juan José Hernandez Aguado María San Martín Paula Ramirez Boix Sergio Cedillo Gómez Noelia López |
| author_facet | Jesús De La Fuente Juan José Hernandez Aguado María San Martín Paula Ramirez Boix Sergio Cedillo Gómez Noelia López |
| author_sort | Jesús De La Fuente |
| collection | DOAJ |
| description | Human papillomavirus (HPV) is one of the main causes of infection-related cancer. The bivalent vaccine (2vHPV) (16/18) and quadrivalent (6/11/16/18) HPV vaccine (4vHPV) have been included in the Spanish vaccination calendar since 2007. The new nonavalent HPV vaccine (9vHPV), approved in Europe in 2015, includes nine HPV types 6/11/16/18/31/33/45/52/58 and has been available in Spain since May 2017. Our study aims to estimate the epidemiological impact and the cost-effectiveness of a girls-only and a gender-neutral vaccination program with 9vHPV compared to the current vaccination program in Spain. A dynamic transmission model simulating the natural history of HPV infections was calibrated to the Spanish setting and applied to estimate costs and quality-adjusted life years (QALYs) associated with vaccination strategies using a payer perspective and a 100-year time horizon. A girls-only vaccination strategy at age 12 years with 9vHPV was found to be a cost-effective strategy compared with 4vHPV (incremental cost-effectiveness ratio (ICER) of €7,718 per QALY). Compared with girls-only vaccination with 4vHPV, gender-neutral vaccination with 9vHPV was associated with further reductions of up to 28.5% in the incidence of cervical intraepithelial neoplasia (CIN) 2/3 and 17.1% in the incidence of cervical cancer, as well as with a 14.0% reduction in cervical cancer mortality. Furthermore, a gender-neutral vaccination program with 9vHPV could potentially be cost-effective considering some parameters as head and neck protection or discount rates, leading to a reduction in the burden of HPV-related diseases in both sexes in the Spanish population. |
| first_indexed | 2024-03-11T11:58:20Z |
| format | Article |
| id | doaj.art-fa87491f775e4312ac4865e0876c7b8a |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T11:58:20Z |
| publishDate | 2019-08-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-fa87491f775e4312ac4865e0876c7b8a2023-11-08T11:55:19ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2019-08-01157-81949196110.1080/21645515.2018.15607701560770Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in SpainJesús De La Fuente0Juan José Hernandez Aguado1María San Martín2Paula Ramirez Boix3Sergio Cedillo Gómez4Noelia López5Hospital Universitario Infanta LeonorHospital Universitario Infanta LeonorMSD SpainMSD SpainMSD SpainMSD SpainHuman papillomavirus (HPV) is one of the main causes of infection-related cancer. The bivalent vaccine (2vHPV) (16/18) and quadrivalent (6/11/16/18) HPV vaccine (4vHPV) have been included in the Spanish vaccination calendar since 2007. The new nonavalent HPV vaccine (9vHPV), approved in Europe in 2015, includes nine HPV types 6/11/16/18/31/33/45/52/58 and has been available in Spain since May 2017. Our study aims to estimate the epidemiological impact and the cost-effectiveness of a girls-only and a gender-neutral vaccination program with 9vHPV compared to the current vaccination program in Spain. A dynamic transmission model simulating the natural history of HPV infections was calibrated to the Spanish setting and applied to estimate costs and quality-adjusted life years (QALYs) associated with vaccination strategies using a payer perspective and a 100-year time horizon. A girls-only vaccination strategy at age 12 years with 9vHPV was found to be a cost-effective strategy compared with 4vHPV (incremental cost-effectiveness ratio (ICER) of €7,718 per QALY). Compared with girls-only vaccination with 4vHPV, gender-neutral vaccination with 9vHPV was associated with further reductions of up to 28.5% in the incidence of cervical intraepithelial neoplasia (CIN) 2/3 and 17.1% in the incidence of cervical cancer, as well as with a 14.0% reduction in cervical cancer mortality. Furthermore, a gender-neutral vaccination program with 9vHPV could potentially be cost-effective considering some parameters as head and neck protection or discount rates, leading to a reduction in the burden of HPV-related diseases in both sexes in the Spanish population.http://dx.doi.org/10.1080/21645515.2018.1560770cervical cancercost-effectivenessgenital wartshpvspainnonavalent hpv vaccine |
| spellingShingle | Jesús De La Fuente Juan José Hernandez Aguado María San Martín Paula Ramirez Boix Sergio Cedillo Gómez Noelia López Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain Human Vaccines & Immunotherapeutics cervical cancer cost-effectiveness genital warts hpv spain nonavalent hpv vaccine |
| title | Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain |
| title_full | Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain |
| title_fullStr | Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain |
| title_full_unstemmed | Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain |
| title_short | Estimating the epidemiological impact and cost-effectiveness profile of a nonavalent HPV vaccine in Spain |
| title_sort | estimating the epidemiological impact and cost effectiveness profile of a nonavalent hpv vaccine in spain |
| topic | cervical cancer cost-effectiveness genital warts hpv spain nonavalent hpv vaccine |
| url | http://dx.doi.org/10.1080/21645515.2018.1560770 |
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