The cost-effectiveness of male HPV vaccination in the United States.

Abstract

INTRODUCTION:

The objective of this study was to estimate the cost-effectiveness of adding human papillomavirus (HPV) vaccination of 12-year-old males to a female-only vaccination program for ages 12-26 years in the United States.

METHODS:

We used a simplified model of HPV transmission to estimate the reduction in the health and economic burden of HPV-associated diseases in males and females as a result of HPV vaccination. Estimates of the incidence, cost-per-case, and quality-of-life impact of HPV-associated health outcomes were based on the literature. The HPV-associated outcomes included were: cervical intraepithelial neoplasia (CIN); genital warts; juvenile-onset recurrent respiratory papillomatosis (RRP); and cervical, vaginal, vulvar, anal, oropharyngeal, and penile cancers.

RESULTS:

The cost-effectiveness of male vaccination depended on vaccine coverage of females. When including all HPV-associated outcomes in the analysis, the incremental cost per quality-adjusted life year (QALY) gained by adding male vaccination to a female-only vaccination program was $23,600 in the lower female coverage scenario (20% coverage at age 12 years) and $184,300 in the higher female coverage scenario (75% coverage at age 12 years). The cost-effectiveness of male vaccination appeared less favorable when compared to a strategy of increased female vaccination coverage. For example, we found that increasing coverage of 12-year-old girls would be more cost-effective than adding male vaccination even if the increased female vaccination strategy incurred program costs of $350 per additional girl vaccinated.

CONCLUSIONS:

HPV vaccination of 12-year-old males might potentially be cost-effective, particularly if female HPV vaccination coverage is low and if all potential health benefits of HPV vaccination are included in the analysis. However, increasing female coverage could be a more efficient strategy than male vaccination for reducing the overall health burden of HPV in the population.

• Authors: Harrell W Chesson, Donatus U Ekwueme, Mona Saraiya, Eileen F Dunne, Lauri E Markowitz
• Journal: Vaccine (Vaccine) Vol. 29 Issue 46 Pg. 8443-50 (Oct 26 2011) ISSN: 1873-2518 [Electronic] Netherlands
• PMID: 21816193 (Publication Type: Journal Article)
• Copyright: Published by Elsevier Ltd.

Chemical References

• Papillomavirus Vaccines

Topics

• Adolescent
• Adult
• Child
• Cost-Benefit Analysis
• Female
• Humans
• Incidence
• Male
• Models, Statistical
• Papillomavirus Infections (economics, epidemiology, prevention & control, transmission)
• Papillomavirus Vaccines (administration & dosage, economics, immunology)
• Quality of Life
• United States (epidemiology)
• Vaccination (economics, methods)
• Young Adult