Burden of HPV-Related Diseases in the Czech Republic: Model-Based Study

OBJECTIVES: Human papillomavirus (HPV) infections are among the most prevalent sexually transmitted infections worldwide and are associated with various cancers. This model-based study assessed the burden of HPV-related diseases in the Czech Republic and evaluated the cost-effectiveness of a potential 9vHPV catch-up vaccination programme.

METHODS: A Markov multistate model was developed to calculate the lifetime health and economic outcomes of HPV infections and vaccination, separately for 11-years old males and females. 3% discount rate was used. Probabilistic sensitivity analysis was conducted to determine the robustness of the results.

RESULTS: Considering the prevailing vaccination rates, the total QALYs for the female and male cohorts were observed to be higher in the vaccination scenario than in the non-vaccination scenario, with a difference of 122,246 and 200,852 QALYs, respectively. Total of 329 cancer-related deaths were prevented in both cohorts. In the PSA of the model with a female population, vaccination was the dominant strategy in 99.3% of the iteration. In remaining 0.7% of cases, the average ICER value was 796 CZK/QALY. In the male population, vaccination was the dominant strategy in 80.3% of iterations. In 19.7% of cases, the average ICER was 452 CZK/QALY. The implementation of catch-up vaccination in the 15-21 age category would result in a notable increase in QALYs and a reduction of deaths and LYLs. The ICER was calculated to be dominant for all analysed catch-up vaccination rates (10%, 20%, 30%) in female cohort. In the male cohort, the ICERs for catch-up vaccination remained consistently low, ranging from 1,753 CZK/QALY to 1,127 CZK/QALY.

CONCLUSIONS: The results emphasised the extensive benefits of the HPV vaccination. The results strongly encourage the implementation of the 9vHPV catch-up vaccination programme in the Czech Republic to address the current immunisation gap and extend the benefits of the HPV vaccination to older age groups who missed the initial vaccinations.