Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom
**Background:** The United Kingdom (UK) switched from using the 4-valent human papillomavirus (HPV) vaccine (Gardasil®) to the 9-valent vaccine (Gardasil 9®) in 2021. **Objective:** To estimate and compare the health and economic outcomes of 2 HPV vaccination programs in the UK targeting girls and...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2022-06-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/001c.34721 |
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| _version_ | 1823860349325017088 |
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| author | Kwame Owusu-Edusei Cody Palmer Olga Ovcinnikova Giampiero Favato Vincent Daniels |
| author_facet | Kwame Owusu-Edusei Cody Palmer Olga Ovcinnikova Giampiero Favato Vincent Daniels |
| author_sort | Kwame Owusu-Edusei |
| collection | DOAJ |
| description | **Background:** The United Kingdom (UK) switched from using the 4-valent human papillomavirus (HPV) vaccine (Gardasil®) to the 9-valent vaccine (Gardasil 9®) in 2021.
**Objective:** To estimate and compare the health and economic outcomes of 2 HPV vaccination programs in the UK targeting girls and boys aged 12-13 years from the perspective of the UK National Health Service. The 2 vaccination strategies were (1) universal vaccination 4-valent (UV4V), using the 4-valent HPV vaccine (4vHPV), and (2) universal vaccination 9-valent (UV9V), using the 9-valent HPV vaccine (9vHPV).
**Methods:** A deterministic heterosexual compartmental disease transmission model was used to track health and economic outcomes over a 100-year time horizon. Outcomes were discounted at an annual rate of 3.5% and 1.5%. All costs were adjusted to 2020 British pounds (£). Health outcomes were measured in quality-adjusted life-years (QALYs), and the summary results were presented as incremental cost-effectiveness ratios (£/QALY gained) when comparing UV4V with UV9V.
**Results:** Using the same vaccine coverage for both programs, the total cumulative cases of HPV-related health outcomes tracked over the 100-year horizon indicated that the relative number of cases averted (UV9V vs UV4V) ranged from 4% (anal male cancers and deaths) to 56% (cervical intraepithelial neoplasia [CIN1]). Assuming that 9vHPV cost £15.18 more than 4vHPV (a cost differential based on discounted list prices), the estimated incremental cost-effectiveness ratio was £8600/QALY gained when discounted at 3.5%, and £3300/QALY gained when discounted at 1.5%. The estimated incremental cost-effectiveness ratios from the sensitivity analyses remained <£28000/QALY over a wide range of parameter inputs and demonstrated that disease utilities, discount rate, and vaccine efficacy were the 3 most influential parameters.
**Discussion:** Consistent with other published studies, the results from this study found that the 9vHPV vaccine prevented a substantial number of cases when compared with the 4vHPV vaccine and was highly cost-effective.
**Conclusions:** These results demonstrate that replacing universal 4vHPV with 9vHPV can prevent a substantial additional number of HPV-related cases/deaths (in both women and men) and remain cost-effective over a range of 9vHPV price premiums. |
| format | Article |
| id | doaj-art-6e4f438baa8d4a29bc288e0130ec851b |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-6e4f438baa8d4a29bc288e0130ec851b2025-02-10T16:12:40ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362022-06-0191Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United KingdomKwame Owusu-EduseiCody PalmerOlga OvcinnikovaGiampiero FavatoVincent Daniels**Background:** The United Kingdom (UK) switched from using the 4-valent human papillomavirus (HPV) vaccine (Gardasil®) to the 9-valent vaccine (Gardasil 9®) in 2021. **Objective:** To estimate and compare the health and economic outcomes of 2 HPV vaccination programs in the UK targeting girls and boys aged 12-13 years from the perspective of the UK National Health Service. The 2 vaccination strategies were (1) universal vaccination 4-valent (UV4V), using the 4-valent HPV vaccine (4vHPV), and (2) universal vaccination 9-valent (UV9V), using the 9-valent HPV vaccine (9vHPV). **Methods:** A deterministic heterosexual compartmental disease transmission model was used to track health and economic outcomes over a 100-year time horizon. Outcomes were discounted at an annual rate of 3.5% and 1.5%. All costs were adjusted to 2020 British pounds (£). Health outcomes were measured in quality-adjusted life-years (QALYs), and the summary results were presented as incremental cost-effectiveness ratios (£/QALY gained) when comparing UV4V with UV9V. **Results:** Using the same vaccine coverage for both programs, the total cumulative cases of HPV-related health outcomes tracked over the 100-year horizon indicated that the relative number of cases averted (UV9V vs UV4V) ranged from 4% (anal male cancers and deaths) to 56% (cervical intraepithelial neoplasia [CIN1]). Assuming that 9vHPV cost £15.18 more than 4vHPV (a cost differential based on discounted list prices), the estimated incremental cost-effectiveness ratio was £8600/QALY gained when discounted at 3.5%, and £3300/QALY gained when discounted at 1.5%. The estimated incremental cost-effectiveness ratios from the sensitivity analyses remained <£28000/QALY over a wide range of parameter inputs and demonstrated that disease utilities, discount rate, and vaccine efficacy were the 3 most influential parameters. **Discussion:** Consistent with other published studies, the results from this study found that the 9vHPV vaccine prevented a substantial number of cases when compared with the 4vHPV vaccine and was highly cost-effective. **Conclusions:** These results demonstrate that replacing universal 4vHPV with 9vHPV can prevent a substantial additional number of HPV-related cases/deaths (in both women and men) and remain cost-effective over a range of 9vHPV price premiums.https://doi.org/10.36469/001c.34721 |
| spellingShingle | Kwame Owusu-Edusei Cody Palmer Olga Ovcinnikova Giampiero Favato Vincent Daniels Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom Journal of Health Economics and Outcomes Research |
| title | Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom |
| title_full | Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom |
| title_fullStr | Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom |
| title_full_unstemmed | Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom |
| title_short | Assessing the Health and Economic Outcomes of a 9-Valent HPV Vaccination Program in the United Kingdom |
| title_sort | assessing the health and economic outcomes of a 9 valent hpv vaccination program in the united kingdom |
| url | https://doi.org/10.36469/001c.34721 |
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