Cost-effectiveness of human papillomavirus vaccination for prevention of cervical cancer in Taiwan
Journal
BMC Health Services Research
Journal Volume
10
Pages
11
Date Issued
2010
Author(s)
Abstract
Background. Human papillomavirus (HPV) infection has been shown to be a major risk factor for cervical cancer. Vaccines against HPV-16 and HPV-18 are highly effective in preventing type-specific HPV infections and related cervical lesions. There is, however, limited data available describing the health and economic impacts of HPV vaccination in Taiwan. The objective of this study was to assess the cost-effectiveness of prophylactic HPV vaccination for the prevention of cervical cancer in Taiwan. Methods. We developed a Markov model to compare the health and economic outcomes of vaccinating preadolescent girls (at the age of 12 years) for the prevention of cervical cancer with current practice, including cervical cytological screening. Data were synthesized from published papers or reports, and whenever possible, those specific to Taiwan were used. Sensitivity analyses were performed to account for important uncertainties and different vaccination scenarios. Results. Under the assumption that the HPV vaccine could provide lifelong protection, the massive vaccination among preadolescent girls in Taiwan would lead to reduction in 73.3% of the total incident cervical cancer cases and would result in a life expectancy gain of 4.9 days or 8.7 quality-adjusted life days at a cost of US$324 as compared to the current practice. The incremental cost-effectiveness ratio (ICER) was US$23,939 per life year gained or US$13,674 per quality-adjusted life year (QALY) gained given the discount rate of 3%. Sensitivity analyses showed that this ICER would remain below US$30,000 per QALY under most conditions, even when vaccine efficacy was suboptimal or when vaccine-induced immunity required booster shots every 13 years. Conclusions. Although gains in life expectancy may be modest at the individual level, the results indicate that prophylactic HPV vaccination of preadolescent girls in Taiwan would result in substantial population benefits with a favorable cost-effectiveness ratio. Nevertheless, we should not overlook the urgency to improve the compliance rate of cervical screening, particularly for older individuals. ? 2010 Liu et al; licensee BioMed Central Ltd.
SDGs
Other Subjects
Wart virus vaccine; article; child; comparative study; cost benefit analysis; economics; female; health care cost; human; life expectancy; mass screening; mortality; probability; quality adjusted life year; quality of life; Taiwan; uterine cervix tumor; vagina smear; Child; Cost-Benefit Analysis; Direct Service Costs; Female; Humans; Life Expectancy; Markov Chains; Mass Screening; Papillomavirus Vaccines; Quality of Life; Quality-Adjusted Life Years; Taiwan; Uterine Cervical Neoplasms; Vaginal Smears
Type
journal article
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