Variables Seen in Cost Effectiveness of HPV Vaccine

Optimal cost effectiveness may depend on achieving universal coverage in 12-year-old girls

WEDNESDAY, Aug. 20 (HealthDay News) -- Optimizing the cost effectiveness of human papillomavirus (HPV) vaccination depends on several factors: the duration of vaccine immunity, achieving universal coverage in pre-adolescent girls, targeting catch-up vaccinations among young women and revising screening guidelines, according to a report published in the Aug. 21 issue of the New England Journal of Medicine.

Jane J. Kim, Ph.D., of the Harvard School of Public Health in Boston, and a colleague used computer models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating several age groups: 12-year-old girls, and women at ages 18, 21 and 26 as part of a catch-up program.

The researchers found that the cost-effectiveness ratio per quality-adjusted life-year gained was considerably lower for vaccinating 12-year-old girls ($43,600) compared to vaccinating women at ages 18, 21 and 26 ($97,300, $120,400 and $152,700, respectively). But these figures were based on the assumption that vaccination provides lifelong immunity. In the event that immunity declines after 10 years, the cost effectiveness of vaccinating 12-year-old girls would increase to more than $140,000 and catch-up strategies would be less cost effective than screening alone, according to the report.

"With so many essential questions still unanswered, there is good reason to be cautious about introducing large-scale vaccination programs," states the author of an accompanying editorial. "Instead, we should concentrate on finding more solid answers through research rather than base consequential and costly decisions on yet unproven assumptions."

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