Human Papilloma Virus in Italy: Cost of Illness and Potential Savings Due to HPV9 Primary Prevention in Adult Women

OBJECTIVES: Human papillomavirus (HPV) is a major cause of infection-related cancers in men and women, imposing a significant burden on healthcare systems. This study aimed to estimate the epidemiological and economic impact of the HPV vaccination strategy in adults in Italy, considering the total direct medical costs associated with nine major HPV-related diseases.

METHODS: An incidence-based model was developed to evaluate the costs and health outcomes of HPV-related diseases in Italy, using national data from 2019. The study identified HPV-related pathologies, such as invasive cervical cancer, cervical dysplasia, and genitourinary, anal, oropharyngeal cancers, and anogenital warts, using ICD-9CM codes. Costs for each incident event by age were extrapolated from existing literature and stratified by age and event type. Vaccination coverage for women aged 30-34 was set at 30% (70% of those participating in organized screening) with vaccine efficacy based on long-term follow-up studies of 4HPV and 9HPV vaccines. The analysis was conducted from both National Health System and societal perspectives over a lifetime horizon.

RESULTS: The model estimated over 75,500 hospitalizations for HPV-related events, with 86% being condylomas or CIN2+, 6% cervical cancer, and 8% other lesions. Vaccinating women aged 30-34 could reduce over 13,200 cases (-25% of total lesions) within the considered timeframe. The current economic burden was estimated at €357 million for those over 30, with cervical cancer comprising 34% of the total cost, followed by CIN2+ (27%) and genitourinary cancers (24%). Adult vaccination could potentially reduce expenses by over €80.6 million, with €63.9 million in direct healthcare costs, against an annual vaccination cost of just over €12 million for this population.

CONCLUSIONS: This study provides a preliminary estimate of the direct and indirect costs of HPV-related diseases in women over 30 and highlights the potential economic benefits of implementing vaccination in this population.