PharmacoEconomics & Outcomes News 586 - 5 Sep 2009

HPV vaccination, a cost-effectivestrategy in The Netherlands

In The Netherlands, the addition of humanpapillomavirus (HPV) vaccination of 12-year-old girls tothe already existing screening programme appears to bea cost-effective strategy, compared with screeningalone.

To examine the costs and effects of adding HPVvaccination to screening for girls to be covered by theDutch National Immunisation Programme, theresearchers adapted an existing Markov model to thesituation in The Netherlands. The model evaluated alifetime cohort of uninfected 12-year-old girls in theabsence of HPV vaccination (screening alone) and alsowhen HPV vaccination was added to screening. Bothdirect and indirect medical costs (2008 values) wereevaluated. Costs and life years were discounted at 4%and 1.5%, respectively, per half year.

In the base-case analysis, vaccination was expected toreduce the cervical cancer and cervical epithelialneoplasia stage 2 cases by 74% and 57%, respectively,compared with non-vaccination. It was estimated thatimplementing HPV vaccination would result in anincremental cost-effectiveness ratio of €22 7000 perlife-year gained or €18 500 per QALY. Sensitivityanalyses revealed that the ICER of adding HPVvaccination to regular screening was sensitive to thevaccine price, discount rate and duration of vaccine-induced protection; initial vaccination supported byboosting was also found to be a cost-effective strategy.Rogoza RM, et al. Cost effectiveness of prophylactic vaccination against humanpapillomavirus 16/18 for the prevention of cervical cancer: adaptation of anexisting cohort model to the situation in the Netherlands. Vaccine 27: 4776-4783,No. 35, 30 Jun 2009 801151295

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PharmacoEconomics & Outcomes News 5 Sep 2009 No. 5861173-5503/10/0586-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved