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 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.
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