Cost-effectiveness of adding vaccination with the AS04-adjuvanted human papillomavirus 16/18 vaccine to cervical cancer screening in Hungary

Abstract

BackgroundThe cervical cancer screening program implemented in Hungary to date has not been successful. Along with screening, vaccination is an effective intervention to prevent cervical cancer. The aim of this study was to assess the cost-effectiveness of adding vaccination with the human papillomavirus 16/18 vaccine to the current cervical cancer screening program in Hungary.MethodsWe developed a cohort simulation state-transition Markov model to model the life course of 12-year-old girls. Eighty percent participation in the HPV vaccination program at 12 years of age was assumed. Transitional probabilities were estimated using data from the literature. Local data were used regarding screening participation rates, and the costs were estimated in US $. We applied the purchasing power parity exchange rate of 129 HUF/$ to the cost data. Only direct health care costs were considered. We used a 3.7% discount rate for both the cost and quality-adjusted life years (QALYs). The time horizon was 88 years.ResultsInclusion of HPV vaccination at age 12 in the cervical cancer prevention program was predicted to be cost-effective. The incremental cost-effectiveness ratio (ICER) of adding HPV vaccination to the current national cancer screening program was estimated to be 27 588 $/QALY. The results were sensitive to the price of the vaccine, the discount rate, the screening participation rate and whether herd immunity was taken into account.ConclusionsOur modeling analysis showed that the vaccination of 12-year-old adolescent girls against cervical cancer with the AS04-adjuvanted human papillomavirus 16/18 vaccine would be a cost-effective strategy to prevent cervical cancer in Hungary.

Public health value of universal HPV vaccination

“…The reported data from the literature show a different economic interpretation in the mentioned countries (see Table 4.) of a substantial answer to a correct interpretation of the concepts on health rights (74,65,75,76,56,77,78,79,80 Published studies on cost effectiveness of HPV vaccination suggest that vaccination against HPV can be used and can be cost effective. Over 64 countries around the world were included in cost effectiveness analyses of HPV vaccination (81).…”

Prevention of human papillomavirus (HPV) infection and cervical cancer in China: How does HPV vaccination bring about benefits to Chinese women?

“…The infection can be detected in more than 95% of carcinoma issues (2). So far, more than 100 different HPV genotypes have been detected, and among them type 16,18,31,33,35,39,45,51,52,56,58,59, and 68 are a high-risk for cervical carcinoma. The most common genotypes among infected women are 16, 18, 31, 58, and 52, accounting for approximately half of HPV infections (3).…”

Reimbursed Costs of Management of Uterine Cervical Lesions in Poland - a Descriptive Analysis of Data from the National Health Fund and the Ministry of Health

“…Pharmacoeconomic modelling proved various degrees of HPV vaccination costeffectiveness for many countries (9)(10)(11)(12) and it was used to make decisions on their reimbursement. Also, HPV testing has proven to be cost-effective in many countries (13) but such analyses for Poland have not been performed yet.…”