Title |
A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program
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Published in |
Sexual Health, August 2007
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DOI | 10.1071/sh07043 |
Pubmed ID | |
Authors |
Shalini Kulasingam, Luke Connelly, Elizabeth Conway, Jane S. Hocking, Evan Myers, David G. Regan, David Roder, Jayne Ross, Gerard Wain |
Abstract |
The cost-effectiveness of adding a human papillomavirus (HPV) vaccine to the Australian National Cervical Screening Program compared to screening alone was examined. A Markov model of the natural history of HPV infection that incorporates screening and vaccination was developed. A vaccine that prevents 100% of HPV 16/18-associated disease, with a lifetime duration of efficacy and 80% coverage offered through a school program to girls aged 12 years, in conjunction with current screening was compared with screening alone using cost (in Australian dollars) per life-year (LY) saved and quality-adjusted life-year (QALY) saved. Sensitivity analyses included determining the cost-effectiveness of offering a catch-up vaccination program to 14-26-year-olds and accounting for the benefits of herd immunity. Vaccination with screening compared with screening alone was associated with an incremental cost-effectiveness ratio (ICER) of $51 103 per LY and $18 735 per QALY, assuming a cost per vaccine dose of $115. Results were sensitive to assumptions about the duration of vaccine efficacy, including the need for a booster ($68 158 per LY and $24 988 per QALY) to produce lifetime immunity. Accounting for herd immunity resulted in a more attractive ICER ($36 343 per LY and $13 316 per QALY) for girls only. The cost per LY of vaccinating boys and girls was $92 052 and the cost per QALY was $33 644. The cost per LY of implementing a catch-up vaccination program ranged from $45 652 ($16 727 per QALY) for extending vaccination to 14-year-olds to $78 702 ($34 536 per QALY) for 26-year-olds. These results suggest that adding an HPV vaccine to Australia's current screening regimen is a potentially cost-effective way to reduce cervical cancer and the clinical interventions that are currently associated with its prevention via screening alone. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | 2% |
Australia | 2 | 2% |
Denmark | 1 | <1% |
Brazil | 1 | <1% |
Unknown | 99 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 20 | 19% |
Student > Ph. D. Student | 18 | 17% |
Researcher | 15 | 14% |
Student > Postgraduate | 11 | 10% |
Student > Doctoral Student | 6 | 6% |
Other | 18 | 17% |
Unknown | 17 | 16% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 38 | 36% |
Social Sciences | 9 | 9% |
Pharmacology, Toxicology and Pharmaceutical Science | 7 | 7% |
Economics, Econometrics and Finance | 6 | 6% |
Nursing and Health Professions | 4 | 4% |
Other | 15 | 14% |
Unknown | 26 | 25% |