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Volume 14, Number 2—February 2008
Research

Cost-effectiveness of Human Papillomavirus Vaccination in the United States

Harrell W. Chesson*Comments to Author , Donatus U. Ekwueme*, Mona Saraiya*, and Lauri E. Markowitz*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Main Article

Table 2

One-way sensitivity analyses: estimated cost per QALY gained by adding routine vaccination of 12-y-old girls to existing cervical cancer screening in the United States*

Parameter or parameter set varied Values applied in sensitivity analysis Cost/QALY gained
Excluding anal, vaginal, vulvar, oropharyngeal cancers, $US Including anal, vaginal, vulvar, oropharyngeal cancers, $US
None NA 10,294 8,137
Vaccine cost per series (base case = $360) $300, $490 5,811–20,009 4,237–16,587
Vaccine efficacy (base case = 100%) 95%, 99% 10,566–11,710 8,374–9,369
Cost of cervical cancer, CIN 1–CIN 3, genital warts* Base case ±25% 6,142–14,446 4,332–11,953
Reduction in quality of life due to HPV-related health outcomes Base case ±50%† 7,720–15,519 6,141–12,135
Incidence rates of cervical cancer, CIN 1–CIN 3, genital warts‡ Base case ±25%† 6,999–16,333 5,181–13,379
% of health outcomes attributable to HPV vaccine types Base case ±20% 6,014–17,020 4,400–13,987
Discount rate (base case = 3%) 0%, 5% 675–24,901 <0–21,966
Time horizon (base case = 100 y) 25 y, 50 y 21,600–81,786 19,943–81,398

*When key parameter values were varied in the population model of quadrivalent HPV vaccine (excluding herd immunity). QALY, quality-adjusted life year; HPV, human papillomavirus; NA, not applicable; CIN, cervical intraepithelial neoplasia.
†See text and Technical Appendix for details.
‡And, when applicable, anal, vaginal, vulvar, and oropharyngeal cancers.

Main Article

Page created: July 21, 2010
Page updated: July 21, 2010
Page reviewed: July 21, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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