TITLE

Cost-effectiveness of different human papillomavirus vaccines in Singapore

AUTHOR(S)
Lee, Vernon J.; Tay, Sun Kuie; Teoh, Yee Leong; Tok, Mei Yin
PUB. DATE
January 2011
SOURCE
BMC Public Health;2011, Vol. 11 Issue 1, p203
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Human papillomavirus (HPV) vaccines are widely available and there have been studies exploring their potential clinical impact and cost-effectiveness. However, few studies have compared the cost-effectiveness among the 2 main vaccines available - a bivalent vaccine against HPV 16/18, and a quadrivalent vaccine against 6/ 11/16/18. We explore the cost-effectiveness of these two HPV vaccines in tropical Singapore. Methods: We developed a Markov state-transition model to represent the natural history of cervical cancer to predict HPV infection, cancer incidence, mortality, and costs. Cytologic screening and treatment of different outcomes of HPV infection were incorporated. Vaccination was provided to a cohort of 12-year old females in Singapore, followed up until death. Based on available vaccines on the market, the bivalent vaccine had increased effectiveness against a wider range of HPV types, while the quadrivalent vaccine had effectiveness against genital warts. Incremental cost-effectiveness ratios (ICER) compared vaccination to no-vaccination, and between the two vaccines. Sensitivity analyses explored differences in vaccine effectiveness and uptake, and other key input parameters. Results: For the no vaccination scenario, 229 cervical cancer cases occurred over the cohort's lifetime. The total discounted cost per individual due to HPV infection was SGD$275 with 28.54 discounted life-years. With 100% vaccine coverage, the quadrivalent vaccine reduced cancers by 176, and had an ICER of SGD$12,866 per life-year saved. For the bivalent vaccine, 197 cancers were prevented with an ICER of $12,827 per life-year saved. Comparing the bivalent to the quadrivalent vaccine, the ICER was $12,488 per life-year saved. However, the cost per QALY saved for the quadrivalent vaccine compared to no vaccine was $9,071, while it was $10,392 for the bivalent vaccine, with the quadrivalent vaccine dominating the bivalent vaccine due to the additional QALY effect from reduction in genital warts. The overall outcomes were most sensitive to vaccine cost and coverage. Conclusion: HPV vaccination is a cost-effective strategy, and should be considered a possible strategy to reduce the impact of HPV infection.
ACCESSION #
60411733

 

Related Articles

  • Advancements in the control of genital human papillomavirus infections and related diseases: highlighting Australia's role. Garland, Suzanne M.; Brotherton, Julia M. L.; Fairley, Christopher K.; Gertig, Dorota M.; Saville, Marion // Sexual Health (14485028);Sep2010, Vol. 7 Issue 3, p227 

    An introduction to topics discussed within the issue is presented, including "Cervical Cancer Vaccine Development," by I. H. Frazer, "What Can Surveillance of Genital Warts Tell Us?," by C. K. Fairley and colleagues, and "Monitoring the Control of Human Papillomavirus (HPV) Infection and Related...

  • Inclusion of the benefits of enhanced crossprotection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands. Westra, Tjalke A.; Stirbu-Wagner, Irina; Dorsman, Sara; Tutuhatunewa, Eric D.; de Vrij, Edwin L.; Nijman, Hans W.; Daemen, Toos; Wilschut, Jan C.; Postma, Maarten J. // BMC Infectious Diseases;2013, Vol. 13 Issue 1, p1 

    Background: Infection with HPV 16 and 18, the major causative agents of cervical cancer, can be prevented through vaccination with a bivalent or quadrivalent vaccine. Both vaccines provide cross-protection against HPV-types not included in the vaccines. In particular, the bivalent vaccine...

  • The epidemiological and economic impact of a quadrivalent human papillomavirus (hpv) vaccine in Estonia. Uusküla, Anneli; Müürsepp, Andres; Kawai, Kosuke; Raag, Mait; Jürisson, Mikk; Pillsbury, Matthew // BMC Infectious Diseases;2013, Vol. 13 Issue 1, p1 

    Background: This analysis assessed the epidemiological and economic impact of quadrivalent human papillomavirus (HPV4: 6/11/16/18) vaccination in Estonia. Methods: A dynamic transmission model was used to assess the epidemiological and economic impact of the routine vaccination of 12-year-old...

  • Pap Smear Screening. DeMarco, C. // Alive: Canada's Natural Health & Wellness Magazine;Apr2002, Issue 234, p44 

    Examines the efficacy of pap smear for screening cervical cancer and genital warts by physician George Papanicolaou in the U.S. Recommendation of the medical procedure for sexually active women; Identification of age bracket to be administered by the pap smear; Development of invasive cervical...

  • Estimation of the incidence of genital warts and the cost of illness in Germany: A cross-sectional study. Hillemanns, Peter; Breugelmans, J. Gabrielle; Gieseking, Friederike; Bénard, Stève; Lamure, Emilie; Littlewood, Kavi J.; Petry, Karl U. // BMC Infectious Diseases;2008, Vol. 8 Issue 1, Special section p1 

    Background: Human papillomavirus (HPV) is a necessary cause of cervical cancer. HPV is also responsible for benign condylomata acuminata, also known as genital warts. We assessed the incidence of genital warts in Germany and collected information on their management to estimate the annual cost...

  • Cost-effectiveness of a tetravalent human papillomavirus vaccine in Germany. Hillemanns, Peter; Petry, Karl; Largeron, Nathalie; McAllister, Ruth; Tolley, Keith; Büsch, Katharina // Journal of Public Health (09431853);Apr2009, Vol. 17 Issue 2, p77 

    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...

  • Epidemiological Aspects of Genital Warts in Romania - a 2012 Retrospective Survey. SALAVASTRU, Carmen Maria; NICULESCU, Mihaela Cristina; ZOTA, Alexandra; NICOLA, Gheorghe; MORARIU, Horia Silviu; SOLOVAN, Caius; PATRASCU, Virgil; POPOVICI, Georgeta; VLADUTA, Raluca; PANDURU, Mihaela; TIPLICA, George-Sorin // Maedica - a Journal of Clinical Medicine;2014, Vol. 9 Issue 2, p144 

    Objectives: Genital infection with human papillomavirus (HPV) has become one of the most frequently viral sexually transmitted diseases. The infection may remain asymptomatic, may take the form of external genital warts and may give raise to cervical cancers. The aim of this study was to assess...

  • HPV vax strategy would be well worth it in Mexico.  // PharmacoEconomics & Outcomes News;1/12/2008, Issue 544, p6 

    The article reports on a study which found that a quadrivalent human papillomavirus (HPV) vaccine programme could be a highly effective and cost efficient strategy for declining the incidence of cervical cancer and genital warts in Mexico. The starategies for HPV vaccination are mentioned. It...

  • Identification of a better Homo sapiens Class II HDAC inhibitor through binding energy calculations and descriptor analysis. Tambunan, Usman Sumo Friend; Wulandari, Evi Kristin // BMC Bioinformatics;2010 Supplement 7, Vol. 11, p1 

    Human papillomaviruses (HPVs) are the most common on sexually transmitted viruses in the world. HPVs are responsible for a large spectrum of deseases, both benign and malignant. The certain types of HPV are involved in the development of cervical cancer. In attemps to find additional drugs in...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics