Cost-effectiveness of a tetravalent human papillomavirus vaccine in Germany |
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Authors: | Peter Hillemanns Karl Ulrich Petry Nathalie Largeron Ruth McAllister Keith Tolley Katharina Büsch |
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Institution: | (1) Medizinische Hochschule Hannover, Carl-Neubergstr. 1, 30625 Hannover, Germany;(2) Frauenklinik im Klinikum der Stadt Wolfsburg, Wolfsburg, Germany;(3) Sanofi Pasteur MSD, Lyon, France;(4) Mapi Values, Bollington, UK;(5) Sanofi Pasteur MSD, Leimen, Germany |
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Abstract: | Aim Clinical trials have demonstrated the efficacy of the tetravalent human papillomavirus (HPV) vaccination in the prevention
of cervical cancer and genital warts associated with HPV types 6, 11, 16 and 18. We used an empirically calibrated Markov
cohort model of the natural history of HPV to assess the cost-effectiveness of the vaccine administered to 12-year-old girls
alongside existing cervical screening programmes in Germany.
Subjects and methods The model estimated cervical cancer (CC), cervical intraepithelial neoplasia (CIN) and genital wart lifetime risks and total
lifetime health care costs, life years gained and quality-adjusted life years (QALY) gained. The analysis was conducted from
the perspective of the German health care payer.
Results In the base case (considering a lifetime duration of protection and 100% efficacy) it was estimated that 2,835 cervical cancer
cases and 679 deaths could be prevented among a cohort of 400,000, at an incremental cost per QALY gained of 10,530 €. A total
of 120 girls needed to be vaccinated to prevent 1 case of CC. Cost-effectiveness is sensitive to a duration of protection
of less than 20 years and to the discount rate for costs and benefits.
Conclusion A policy of vaccinating adolescent girls has been recommended by the German Standing Committee on Vaccinations. This study
has demonstrated that such a policy is cost-effective based on thresholds of cost-effectiveness that apply in Germany. |
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Keywords: | Human papillomavirus (HPV) vaccine Cost-effectiveness Germany |
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