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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 3

Multiway 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 Cost per QALY gained
Excluding anal, vaginal, vulvar cancers, $US. Including anal, vaginal, vulvar cancers, $US
Higher cost per case and larger reduction in quality of life for all HPV-related health outcomes 4,606 3,262
Lower cost per case and smaller reduction in quality of life for all HPV-related health outcomes 21,779 17,825
Discount rate = 0%; time horizon = 100 y 675 <0
Discount rate = 5%; time horizon = 50 y 36,503 34,539
Higher percentage of health outcomes attributable to HPV vaccine types; higher incidence of HPV-related health outcomes 3,815 1,882
Lower percentage of health outcomes attributable to HPV vaccine types; lower incidence of HPV-related health outcomes 24,250 20,265
All variables above (best-case scenario) <0 <0
All variables above (worst-case scenario) 122,976 115,896

*When key parameter values were simultaneously varied in the population model of quadrivalent HPV vaccine (excluding herd immunity). QALY, quality-adjusted life year; HPV, human papillomavirus;
†The lower and upper bound ranges were the same as described in the1-way sensitivity analyses, except for the time horizon, which was varied from 50 y to 100 y.

Main Article

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