Public health impact and cost-effectiveness of switching from bivalent to nonavalent vaccine for human papillomavirus in Norway: incorporating the full health impact of all HPV-related diseases.

Abstract

AIM:

The objective of this study was to estimate and compare the cost-effectiveness of switching from a bivalent to a nonavalent human papillomavirus (HPV) vaccination program in Norway, incorporating all nonavalent vaccine-preventable HPV-related diseases and in the context of the latest cervical cancer screening program.

METHODS:

A well-established dynamic transmission model of the natural history of HPV infection and disease was adapted to the Norwegian population. We determined the number of cases of HPV-related diseases and subsequent number of deaths, and the economic burden of HPV-related disease under the current standard of care conditions of bivalent and nonavalent vaccinations of girls and boys aged 12 years.

RESULTS:

Compared to bivalent vaccination, nonavalent vaccination averted an additional 4,357 cases of HPV-related cancers, 421,925 cases of genital warts, and 543 cases of recurrent respiratory papillomatosis (RRP) over a 100-year time horizon. Nonavalent vaccination also averted an additional 1,044 deaths over the 100-year time horizon when compared with bivalent vaccination. Total costs were higher for the nonavalent strategy (10.5 billion NOK [€1.03 billion] vs. 9.3-9.4 billion NOK [€915-925 million] for bivalent vaccination). A switch to nonavalent vaccination had a higher vaccination cost (4.4 billion NOK [€433 million] vs. 2.7 billion NOK [€266 million] for bivalent vaccination) but resulted in a savings of 627-694 million NOK [€62-68 million] in treatment costs. A switch to nonavalent vaccination demonstrated an incremental cost-effectiveness ratio of 102,500 NOK (€10,086) per QALY versus bivalent vaccination.

CONCLUSIONS:

Using a model that incorporated the full range of HPV-related diseases, and the latest cervical cancer screening practices, we found that switching from bivalent to nonavalent vaccination would be considered cost-effective in Norway.

• Authors: Ibrahim Diakite, Sylvi Nguyen, Ugne Sabale, Andrew Pavelyev, Kunal Saxena, Athar Ali Tajik, Wei Wang, Cody Palmer
• Journal: Journal of medical economics (J Med Econ) 2023 Jan-Dec Vol. 26 Issue 1 Pg. 1085-1098 ISSN: 1941-837X [Electronic] England
• PMID: 37608730 (Publication Type: Journal Article)

Chemical References

• Vaccines, Combined
• Papillomavirus Vaccines

Topics

• Male
• Female
• Humans
• Papillomavirus Infections (prevention & control, epidemiology)
• Human Papillomavirus Viruses
• Uterine Cervical Neoplasms (prevention & control)
• Cost-Benefit Analysis
• Vaccines, Combined
• Public Health
• Early Detection of Cancer
• Papillomavirus Vaccines (therapeutic use)
• Norway (epidemiology)
• Quality-Adjusted Life Years