Abstract
The human papillomavirus (HPV) vaccine was introduced into Thailand's national immunization program in 2017 for 11-12 year old school girls. The objectives of this study were to examine the epidemiological consequences and cost-effectiveness of a routine quadrivalent HPV (4vHPV) vaccination and the routine 4vHPV vaccination plus 5-year catch-up vaccination by comparing with cervical cancer screening only (no vaccination) in Thailand. A transmission dynamic model was used to assess the cost-effectiveness of the routine 4vHPV vaccination and the routine 4vHPV vaccination plus catch-up vaccination, compared with no vaccination (screening only) in Thai population. The vaccination coverage rate assumptions were 95% in 11-12-year-old girls for the routine vaccination and 70% in 13-24 year-old females for the 5-year catch-up vaccination. Vaccination costs, direct medical costs of HPV-related diseases, and the number of quality of life years (QALYs) gained were calculated for over a 100-year time horizon with discount rate of 3%. The model indicated that the routine 4vHPV vaccination and the routine plus catch-up 4vHPV vaccination strategies could prevent approximately 434,130 and 472,502 cumulative cases of cervical cancer, 182,234 and 199,068 cumulative deaths from cervical cancer and 12,708,349 and 13,641,398 cumulative cases of HPV 6/11 related genital warts, respectively, when compared with no vaccination over 100 years. The estimated cost per QALY gained (ICER) when compared to no vaccination in Thailand was 8,370 THB/QALY for the routine vaccination and 9,650 THB/QALY for the routine with catch-up vaccination strategy. Considering the recommended threshold of 160,000 THB/QALY for Thailand, the implementation of the routine 4vHPV vaccination either alone or plus the catch-up vaccination was cost-effective as compared to the cervical cancer screening only.
Highlights
Human papillomavirus (HPV) infection is the most common sexually transmitted infection for both women and men, and can be passed through genital or skin-to-skin contact [1, 2]
The routine 4vHPV vaccination and the routine plus catch-up 4vHPV vaccination strategies would cumulatively prevent cervical cancer for 434,130 cases (62.1%) and 472,502 cases (67.6%) over 100 years respectively when compared to no vaccination
The routine plus catch-up vaccination would cumulatively prevent 2,133,772 cases of HPV16/18 related CIN1, 4,346,356 cases of HPV16/18 related CIN2/3, 574,097 cases of HPV6/11 related CIN1 and 13,641,398 cases of HPV6/11 related genital warts among women and men compared with no vaccination
Summary
Human papillomavirus (HPV) infection is the most common sexually transmitted infection for both women and men, and can be passed through genital or skin-to-skin contact [1, 2]. HPV infection occurs almost immediately after becoming sexually active. Around half of these cases involve high-risk HPVs that are responsible for 5% of all cancers worldwide with 570,000 newly diagnosed female patients, and 60,000 newly diagnosed male patients annually [3] HPV vaccines, or HPV-virus-like particles (VLPs), effectively prevent HPV infections [4]. The human papillomavirus (HPV) vaccine was introduced into Thailand’s national immunization program in 2017 for 11–12 year old school girls. The objectives of this study were to examine the epidemiological consequences and cost-effectiveness of a routine quadrivalent HPV (4vHPV) vaccination and the routine 4vHPV vaccination plus 5-year catch-up vaccination by comparing with cervical cancer screening only (no vaccination) in Thailand
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