Estimating Treatment Cost Savings of Gender-Neutral Nonavalent HPV Vaccination in Mexico

OBJECTIVES: In 2012, HPV vaccination was introduced in the Mexican National Immunization Program targeting all 11-year-old girls, while vaccination for boys is only available in the private market. This study aimed to estimate the cost savings associated with implementing gender-neutral vaccination (GNV) in 11-year-olds with the nonavalent HPV vaccine compared to the bivalent and quadrivalent vaccines in Mexico.

METHODS: A dynamic transmission model was used to simulate the natural history of HPV infections and estimate the costs related to HPV-associated diseases. The diseases included in the economic model were cervical, vaginal, vulvar, anal, head and neck cancers, genital warts and cervical intraepithelial neoplasia (CIN) grade 1 and 2+ for different HPV genotypes (6/11/16/18/31/33/45/52/58). The analysis assumed two-dose schedule and a time horizon of 100 years; the results included the costs of HPV-associated diseases and the reduction in avoided cases. The discount rate was 5%.

RESULTS: The nonavalent vaccine was estimated to provide more rapid reduction in avoided cases of HPV-associated diseases compared to the bivalent and quadrivalent vaccines. GNV with the nonavalent vaccine would prevent more than 2.7 million cases compared to the bivalent vaccine, and more than 650 thousand cases compared to the quadrivalent vaccine. The estimated cost savings from avoiding clinical treatment for these diseases would exceed 52 billion Mexican pesos compared to the bivalent vaccine and more than 12 billion Mexican pesos compared to the quadrivalent vaccine. Moreover, the nonavalent vaccine increased the number of avoided cases of CIN, cervical cancer, anal cancer and genital warts.

CONCLUSIONS: Implementing GNV nonavalent HPV vaccination in Mexico would lead to substantial clinical treatment cost savings in Mexico through prevention of new cases of HPV-associated cancers and diseases in both men and women.