Cost-effectiveness of nonavalent vs bivalent HPV vaccine in Polish setting
, 1, 1, 3, 4, 5, 5, 16
Abstract
Objectives: Human papillomavirus (HPV) is a prevalent sexually transmitted infection with significant implications for public health. In Poland, a nationwide vaccination program offers a choice between the 9-valent (9v) and 2-valent (2v) HPV vaccines. We aimed to assess the cost-effectiveness of the 9v vs 2v vaccine from the public payer perspective in Poland. Material and methods: A cost-effectiveness analysis was conducted to compare the public health and economic benefits of using 9v vs 2v vaccine in Poland over 100-year horizon using a previously published deterministic dynamic transmission model. A target population of girls and boys aged 12-13 years was considered. The model was populated with local epidemiological inputs, utilities, and costs, including vaccine and administration costs, as well as costs related to medical procedures for HPV-related diseases. Results: The 9v vaccine reduced the prevalence of HPV infections and HPV-related diseases substantially more than 2v vaccine when both are compared to no vaccination strategy. The total discounted cost savings of using the 9v vaccine instead of 2v, excluding the vaccine costs, amounted to EUR 66 million. The incremental cost-effectiveness ratio amounted to 8094 EUR per quality-adjusted life year, much below the official cost-effectiveness threshold in Poland set up at the three times the annual gross domestic product per capita. 9v cost-effectiveness ratio remained unchanged when shorter time-horizons of 20, 40, 60, or 80 years were considered. Conclusions: Using 9v HPV vaccine in Poland is highly cost-effective compared to the 2v vaccine.
Keywords: vaccinehuman papillomaviruscost-effectivenessPoland
References
- Kombe Kombe AJ, Li B, Zahid A, et al. Epidemiology and Burden of Human Papillomavirus and Related Diseases, Molecular Pathogenesis, and Vaccine Evaluation. Front Public Health. 2020; 8: 552028.
- Chesson HW, Dunne EF, Hariri S, et al. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014; 41(11): 660–664.
- https://www paho org/en/human—papillomavirus—hpv—vaccine (20.07.2023).
- https://www who int/news—room/fact—sheets/detail/cervical—cancer (27.12.2023).
- Bruni L, Albero G, Serrano B, et al. Human Papillomavirus and Related Diseases in the World. Summary Report 10 March 2023. ICO/IARC Information Centre on HPV and Cancer. (HPV Information Centre): 2023.
- Przybylski M, Pruski D, Wszołek K, et al. Prevalence of HPV and Assessing Type-Specific HPV Testing in Cervical High-Grade Squamous Intraepithelial Lesions in Poland. Pathogens. 2023; 12(2).
- Fortes HR, von Ranke FM, Escuissato DL, et al. Recurrent respiratory papillomatosis: A state-of-the-art review. Respir Med. 2017; 126: 116–121.
- Kamolratanakul S, Pitisuttithum P. Human Papillomavirus Vaccine Efficacy and Effectiveness against Cancer. Vaccines (Basel). 2021; 9(12).
- https://www.termedia.pl/ginekologia/Zaszczepiono—ponad—138—tys—dzieci—przeciw—HPV,54002.html#:~:text=W%20ramach%20programu%20bezpłatnych%20szczepień,jest%20populacja%20ponad%20800%20tys. (27.12.2023).
- Baker P, Kelly D, Medeiros R, et al. Eliminating HPV-caused cancers in Europe: Achieving the possible. J Cancer Policy. 2021; 28: 100280.
- https://ec europa eu/commission/presscorner/detail/en/ip_22_702 (27.12.2023).
- Diakite I, Nguyen S, Sabale U, et al. Public health impact and cost-effectiveness of switching from bivalent to nonavalent vaccine for human papillomavirus in Norway: incorporating the full health impact of all HPV-related diseases. J Med Econ. 2023; 26(1): 1085–1098.
- Daniels V, Saxena K, Patterson-Lomba O, et al. Modeling the health and economic implications of adopting a 1-dose 9-valent human papillomavirus vaccination regimen in a high-income country setting: An analysis in the United Kingdom. Vaccine. 2022; 40(14): 2173–2183.
- Elbasha EH, Dasbach EJ, Insinga RP. Model for assessing human papillomavirus vaccination strategies. Emerg Infect Dis. 2007; 13(1): 28–41.
- Demographic Surveys Department. Demographic Yearbook of Poland, Statistics Poland, 2022. https://stat.gov.pl/obszary—tematyczne/roczniki—statystyczne/roczniki—statystyczne/rocznik—demograficzny—2022,3,16.html (26.10.2023).
- Poland. National Accounts Statistics: Main Aggregates and Detailed Tables. 2023: 3514–3554.
- Mercer CH, Tanton C, Prah P, et al. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). Lancet. 2013; 382(9907): 1781–1794.
- Garnett GP, Anderson RM. Factors controlling the spread of HIV in heterosexual communities in developing countries: patterns of mixing between different age and sexual activity classes. Philos Trans R Soc Lond B Biol Sci. 1993; 342(1300): 137–159.
- The social organization of sexuality: sexual practices in the United States. Choice Reviews Online. 1995; 32(08).
- https://statystyki nfz gov pl/Benefits/1a (27.12.2023).
- https://pacjent gov pl/program—profilaktyczny/profilaktyka—raka—szyjki—macicy (27.12.2023).
- https://www gov pl/web/zdrowie/narodowa—strategia—onkologiczna—nso (27.12.2023).
- https://stat.gov.pl/obszary—tematyczne/zdrowie/zdrowie/stan—zdrowia—ludnosci—polski—w—2019—r—,26,1.html (27.12.2023).
- Rokita W. Wartość diagnostyczna cytologii i kolposkopii u kobiet ze śródnabłonkową neoplazją szyjki macicy. Ginekol Pol. 2011; 82: 607–611.
- National Agency for Accreditation and Evaluation of Health (ANAES). Recommadations pour la pratique clinique: conduite à tenir devant un frottis anormal du col de l’utérus. 1998 et actualisation 2002. https://www.has—sante.fr/?id=c_272243 (27.12.2023).
- Analiza ekonomiczna. Szczepionka przeciw wirusowi brodawczaka ludzkiego Cervarix® w profilaktyce zmian przednowotworowych narządów płciowych i odbytu (szyjki macicy, sromu, pochwy i odbytu) oraz raka szyjki macicy i raka odbytu. Pracownia HTA, 2021. https://bipold.aotm.gov.pl/assets/files/zlecenia_mz/2021/041/AW/41_AW_OT.4230.6.2021_Cervarix_AE.pdf (27.12.2023).
- Order No. 21/2023/DSOZ of the President of the National Health Fund of 31.01. 2023. https://baw.nfz.gov.pl/NFZ/document/1669/Zarzadzenie—21_2023_DSOZ (27.12.2023).
- Golicki D, Niewada M. EQ-5D-5L Polish population norms. Arch Med Sci. 2017; 13(1): 191–200.
- Iino H, Hashiguchi M, Hori S. Estimating the range of incremental cost-effectiveness thresholds for healthcare based on willingness to pay and GDP per capita: A systematic review. PLoS One. 2022; 17(4): e0266934.
- Gandjour A. Willingness to pay for new medicines: a step towards narrowing the gap between NICE and IQWiG. BMC Health Serv Res. 2020; 20(1): 343.
- Arora S, Tuffaha H. Cost-effectiveness analysis of human papillomavirus vaccines for the prevention of cervical cancer in India. Asia Pac J Clin Oncol. 2024; 20(1): 55–62.
- Mahumud RA, Alam K, Afroz S, et al. Correction: Cost-effectiveness evaluations of the 9-Valent human papillomavirus (HPV) vaccine: Evidence from a systematic review. PLoS One. 2023; 18(11): e0294379.
- Ng SS, Hutubessy R, Chaiyakunapruk N. Systematic review of cost-effectiveness studies of human papillomavirus (HPV) vaccination: 9-Valent vaccine, gender-neutral and multiple age cohort vaccination. Vaccine. 2018; 36(19): 2529–2544.
- Wondimu A, Postma MJ, van Hulst M. Cost-effectiveness analysis of quadrivalent and nonavalent human papillomavirus vaccines in Ethiopia. Vaccine. 2022; 40(14): 2161–2167.
- Kostaras D, Karampli E, Athanasakis K. Vaccination against HPV virus: a systematic review of economic evaluation studies for developed countries. Expert Rev Pharmacoecon Outcomes Res. 2019; 19(2): 147–158.
