Volume 14, Number 2—February 2008
Research
Cost-effectiveness of Human Papillomavirus Vaccination in the United States
Harrell W. Chesson*
, Donatus U. Ekwueme*, Mona Saraiya*, and Lauri E. Markowitz*
, Donatus U. Ekwueme*, Mona Saraiya*, and Lauri E. Markowitz*
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.
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