Volume 13, Number 1—January 2007
Research
Model for Assessing Human Papillomavirus Vaccination Strategies
, Erik J. Dasbach*, and Ralph P. Insinga*
Table 2
Sensitivity of incremental cost-effectiveness ratios (US $/QALY) of alternative HPV vaccination strategies to changes in inputs*
| Input | F12 only | F12-only+ CUF only | F&M12+ CUF-only | F&M12+ CUF&M† |
|---|---|---|---|---|
| Baseline | 2,964 | 4,666 | 41,803 | 45,056 |
| Cost of vaccination series = $300 | 997 | 2,422 | 33,469 | 36,161 |
| Cost of vaccination series = $500 | 7,553 | 9,900 | 61,250 | 65,810 |
| Utility weights for CIN, CIS, GW = 0.97 | 5,241 | 7,739 | 82,700 | 83,714 |
| Duration of protection = 10 y | Weakly dominated | 21,121 | 54,755 | 54,928 |
| Degree of protection against HPV 6/11/16/18 = 100% | 2,094 | 4,187 | Weakly dominated | 51,436 |
| Degree of protection against HPV 6/11/16/18 = 74% | 4,273 | 5,403 | 39,990 | 43,930 |
| Degree of protection against disease = 87% | 3,116 | 4,922 | 40,269 | 43,974 |
| Coverage with vaccination = 50% | 2,636 | 4,221 | 23,862 | 36,235 |
| Coverage with vaccination = 90% | 3,449 | 5,269 | Weakly dominated | 100,418 |
*Unless specified otherwise, cost of vaccination series is US $360, and duration of protection is lifelong. QALY, quality-adjusted life years; HPV, human papillomavirus; F12-only, female vaccination by age 12; CUF, catch-up female vaccination for ages 12–24; F&M12+CUF only, female and male vaccination by age 12 and CUF; CIN, cervical intraepithelial neoplasia; CIS, carcinoma in situ; GW, genital warts.
†Compared with the preceding nondominated strategy. Strategy A is dominated if there is another strategy, B, that is more effective and less costly than strategy A. The strategy of female and male vaccination by age 12 that did not include a catch-up program was dominated. A strategy is weakly dominated if there is another more effective program that has a lower incremental cost-effectiveness ratio.