Public Health and Economic Impact of Gender-Neutral Nine-Valent Human Papillomavirus Vaccination Program in Algeria

OBJECTIVES: To assess the health and economic impact of gender-neutral vaccination (GNV) with nine-valent HPV vaccine (9vHPV) with vaccine coverage rate (VCR) 80% girls and 60% boys in the 11-12 years old age group in comparison to no vaccination (screening only) from Algerian National Immunization program perspective.

METHODS: A published HPV transmission dynamic model was calibrated to simulate the natural history of HPV infections and estimate the costs associated with HPV-related diseases. Following a detailed data collection, the model was informed with Algeria-specific parameters. The model assumed two-dose schedule over a 100-year time-horizon with lifelong immunity, herd immunity and a discount rate of 3%.

RESULTS: The model demonstrated that 9vHPV GNV may prevent 2,666,893 cases of HPV-related diseases over 100 years. Overall number of prevented HPV-related deaths was 32,263 women and 10,009 men. 58,012 cervical cancer cases (38.3%) and 3,377 head & neck (H&N) cancers cases (30.8%) were averted by 9HPVv in females over 100 years. In males, 16,081 H&N cancers cases (29.7%) and 11,269 (66.6%) recurrent respiratory papillomatosis cases were prevented in the same period. 1,135,008 (65%) cases of anogenital warts in females and 1,133,072 (63%) in males were prevented by 9vHPV. The cumulative number of quality-adjusted life years (QALY) gained over this period was 133,050. Overall decrease of HPV-related disease treatment costs was anticipated to be around $258,364,663 (21.3%) with GNV in the 11-12 years old age bracket in comparison with no vaccination.

CONCLUSIONS: Gender-neutral vaccination with the nine-valent HPV vaccine (VCR: 80% girls and 60% boys) in the 11-12 years old age group may show a significant decrease in the incidence and mortality associated with HPV-related diseases in Algeria. 9HPVv GNV may substantially lower direct medical costs associated with HPV-related diseases.