Análisis de coste-efectividad de la vacunación frente al virus del papiloma humano tipos 6, 11, 16 y 18 en España

Abstract

ObjectivesA vaccine to prevent diseases due to human papillomavirus (HPV) types 6, 11, 16 and 18 is now available in Spain. The objective of this study was to assess the health and economic impact in Spain of implementing a four-valent HPV vaccine alongside existing screening versus screening alone. MethodsA Markov model of the natural history of HPV infection, incorporating screening and vaccination, was adapted to the Spanish context. A vaccine that would prevent 100% of HPV 6, 11, 16 and 18-associated diseases, with a lifetime duration and 80% coverage, given to girls at age 11 plus current screening was compared to screening alone. The analysis was made from the third-party payer perspective and therefore excluded indirect costs such as loss of productivity. ResultsThe incremental cost per life years gained (LYG) and per quality-adjusted life years (QALY) gained for the introduction of HPV vaccination alongside the Spanish cervical cancer screening programme was 8,657 € and 6,493 €, respectively. Sensitivity analyses demonstrated that the cost-effectiveness was stable, but was most sensitive to the discount rate used for costs and benefits. ConclusionsThese analyses demonstrate that adding a four-valent HPV vaccine to the current screening programme in Spain is a cost-effective strategy for reducing the burden of cervical cancer, pre-cancerous lesions and genital warts.