HEALTH AND ECONOMIC IMPACT OF EXTENDING HPV VACCINATION TO ADULTS 20-26 YEARS OF AGE IN FRANCE: A MODELING STUDY
Author(s)
Ruthie Birger, PhD, MSc1, Manon Breau-Brunel, PharmD, MSc2, Lionel Bensimon, PharmD, MSc3, Romain Philippe Moreau, PharmD4, Tufail Malik, PhD1, Vincent Daniels, PhD1.
1Merck & Co., Inc., Rahway, NJ, USA, 2HEOR manager, MSD France, Puteaux, France, 3MSD France, Puteaux, France, 4stève consultants, Angers, France.
1Merck & Co., Inc., Rahway, NJ, USA, 2HEOR manager, MSD France, Puteaux, France, 3MSD France, Puteaux, France, 4stève consultants, Angers, France.
OBJECTIVES: Vaccination against the human papillomavirus (HPV) can prevent multiple types of cancer and other diseases. Until recently, France offered reimbursed vaccination to all individuals aged 11-19 years and to men 20-26 years of age who have sex with men. However, uptake among these groups has remained below the 80% target, leaving many adults unvaccinated. In 2026, the catch-up vaccination program was therefore expanded to include all individuals ≤26 years of age. This study aimed to model the public health and economic impacts of this expanded catch-up program.
METHODS: A published, validated dynamic transmission model was adapted using French demographic, epidemiological, and economic inputs. Outcomes included total and incremental cases of HPV-associated diseases, deaths, costs (including vaccination, cervical cancer screening, and treatment), and quality-adjusted life years (QALYs). A 100-year time horizon and a health care system perspective were used. An annual catch-up vaccination initiation rate of 4.90% was assumed among individuals aged 20-26 years over the first 9 years and 2.45% thereafter.
RESULTS: Compared with the previous French HPV vaccination strategy, expanding catch-up vaccination to all individuals ≤26 years of age was predicted to avert a total of 340,933 additional cases of HPV-associated disease, including 3,520 cancers (1,728 anal, 1,632 cervical, 92 vulvar, and 68 vaginal), 87,734 precancerous cervical lesions, and 249,678 cases of anogenital warts. This corresponded to 29,885 incremental QALYs gained. The additional cost of the expanded catch-up program was €637,793,218, resulting in an incremental cost-effectiveness ratio of €21,341/QALY. Based on the uptake assumptions used in the model, cervical cancer elimination is projected by 2067.
CONCLUSIONS: The recent expansion of catch-up HPV vaccination in France to include all previously unvaccinated individuals ≤26 years of age is predicted to avert substantial disease burden over 100 years and to be cost-effective at a willingness-to-pay threshold of ~€21K/QALY.
METHODS: A published, validated dynamic transmission model was adapted using French demographic, epidemiological, and economic inputs. Outcomes included total and incremental cases of HPV-associated diseases, deaths, costs (including vaccination, cervical cancer screening, and treatment), and quality-adjusted life years (QALYs). A 100-year time horizon and a health care system perspective were used. An annual catch-up vaccination initiation rate of 4.90% was assumed among individuals aged 20-26 years over the first 9 years and 2.45% thereafter.
RESULTS: Compared with the previous French HPV vaccination strategy, expanding catch-up vaccination to all individuals ≤26 years of age was predicted to avert a total of 340,933 additional cases of HPV-associated disease, including 3,520 cancers (1,728 anal, 1,632 cervical, 92 vulvar, and 68 vaginal), 87,734 precancerous cervical lesions, and 249,678 cases of anogenital warts. This corresponded to 29,885 incremental QALYs gained. The additional cost of the expanded catch-up program was €637,793,218, resulting in an incremental cost-effectiveness ratio of €21,341/QALY. Based on the uptake assumptions used in the model, cervical cancer elimination is projected by 2067.
CONCLUSIONS: The recent expansion of catch-up HPV vaccination in France to include all previously unvaccinated individuals ≤26 years of age is predicted to avert substantial disease burden over 100 years and to be cost-effective at a willingness-to-pay threshold of ~€21K/QALY.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE290
Topic
Economic Evaluation, Epidemiology & Public Health, Health Technology Assessment
Disease
Oncology, Vaccines